Introduction
A case study of a 34-year-old female presented with postural orthostatic tachycardia syndrome (POTS) and small intestinal bacterial overgrowth (SIBO). Her main complaints were dizziness and lightheadedness when standing up, especially in the mornings, bloating after meals, chronic fatigue and brain fog throughout the day.
Examination
Examination revealed a right vestibular and right pontomedullary reticular dysfunction. Patient’s orthostatic vitals on the initial exam were as follows: heart rate: 69-104 bpm, blood pressure 135/95, oxygen 98%.
Treatment
Patient was put on a specific SIBO supplement regimen, as well as an initial course of neurological rehabilitation of two sessions per week for 5 weeks. After 3 weeks of neurological rehabilitation, the patient began 20 hours of hyperbaric oxygen therapy. Patient underwent a second course of neurological rehabilitation at a frequency of one session per week for 4 weeks.
Treatment included tilt table therapy, vestibular rehabilitation, somatosensory integration, interactive metronome, neuronal sensory integration, red light/ near infrared therapy, hyperbaric oxygen therapy and more.
Results
At the first re-examination the patient stated that she was not experiencing light headedness or dizziness when standing. She had a decrease in her brain fog and fatigue, as well as an improvement in her digestion. She was able to eat different foods and not experience any painful bloating.
During the first re-examination, right vestibular dysfunction was still present. Improvement in pontomedullary function was observed. Patient vitals were as follows during re-examination: heart rate: 78-103bpm, blood pressure: 134/84 and oxygen 100%.
During the second course of treatment, the patient was given an at home exercise regimen. At the second re-examination, right vestibular dysfunction was attenuated, and there was no more reported brain fog and fatigue. She reported that her digestion felt normal. During the second re-examination, the patient’s vitals were as follows: heart rate: 68-87 bpm, blood pressure: 126/92 and oxygen: 100%.
After the second round of treatment, we began to decrease the patient’s SIBO supplement regimen, and continued to monitor the patient once a month for three months to monitor her progress.
Conclusion
Functional neurological care, supplementation and hyperbaric oxygen therapy has been shown to be effective in the treatment of postural orthostatic tachycardia syndrome and small intestinal bacterial overgrowth. Every patient requires an individualized approach and targeted treatment to achieve optimal results. Please visit our Dysautonomia Program webpage for more information.