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How can postprandial hypotension be treated?

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Posted on Tue, 4 Jul 2017
Question: My husband has postprandial hypotension. It he has fallen, and sometimes he is lightheaded almost half the day. Dr.s don't seem very concerned about diagnosing the cause , even though it is debilitating. He is 65 yrs old five foot five and 123 lbs. With a history of tonsil cancer and colon cancer ,Eight yrs ago but healthy now.
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Answered by Dr. Ilir Sharka (39 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that postprandial hypotension can be considered a sign of autonomic dysfunction.

Sometimes this syndrome is associated to chemotherapy. Paraneoplastic syndrome related to cancer could be another

But, I would recommend first performing a Head Up Tilt test to investigate for possible orthostatic intolerance which is part of autonomic dysfunction.

Other tests to consider would be:

- a chest X ray study
- an abdominal ultrasound
- a cardiac ultrasound
- some blood lab tests (complete blood count, PCR, ESR, kidney and liver function tests, blood electrolytes, etc.).
- Cancer Antigenes (CEA, CA19.9, PSA, etc.) for cancer screening.

Steroids can be helpful if the diagnosis of autonomic dysfunction is confirmed.

I would also recommend some tips to help improve his situation:

- avoid large and hipercaloric meals
- try to eat more frequently and in small portions
- increase salt and fluids intake.

You should discuss with your doctor on the above issues.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (12 minutes later)
No orthostatic reaction. We have had all regularly blood tests done. He has tried all of the solutions you mention. Could varicose veins be a contributing factor? We will see the doctor in three months. By the way he is currently on no medicine.

doctor
Answered by Dr. Ilir Sharka (6 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

I do not think that varicose veins would contribute in this clinical scenario.

A hiatal hernia could trigger this clinical scenario.

For this reason, I would recommend performing a fibrogastroscopy to exclude this possibility.

I would also recommend you to follow the above mentioned tips (eat more frequently and in small meals). Increasing salt intake can help avoid these drops in blood pressure.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

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Practicing since :2001

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How can postprandial hypotension be treated?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would explain that postprandial hypotension can be considered a sign of autonomic dysfunction. Sometimes this syndrome is associated to chemotherapy. Paraneoplastic syndrome related to cancer could be another But, I would recommend first performing a Head Up Tilt test to investigate for possible orthostatic intolerance which is part of autonomic dysfunction. Other tests to consider would be: - a chest X ray study - an abdominal ultrasound - a cardiac ultrasound - some blood lab tests (complete blood count, PCR, ESR, kidney and liver function tests, blood electrolytes, etc.). - Cancer Antigenes (CEA, CA19.9, PSA, etc.) for cancer screening. Steroids can be helpful if the diagnosis of autonomic dysfunction is confirmed. I would also recommend some tips to help improve his situation: - avoid large and hipercaloric meals - try to eat more frequently and in small portions - increase salt and fluids intake. You should discuss with your doctor on the above issues. Hope you will find this answer helpful! Kind regards, Dr. Iliri