Send us a text with a question or thought on this episode ( We cannot replay from this link)
Dr. Zachary Spiritsos shares expert insights on the connections between digestive issues and conditions like POTS, MCAS, and EDS. He explains how these overlapping conditions present with distinct symptom patterns that can help patients better understand their complex health challenges.
• Neurogastroenterologists are “electricians, not plumbers” – focusing on nervous system connections to digestive issues
• POTS typically presents with racing heart upon standing, brain fog, blood pooling, and various GI symptoms
• MCAS features “twitchy” mast cells that react to everything from temperature changes to emotions
• Primary MCAS symptoms include skin manifestations (itching, rashes), ENT issues, and GI symptoms like unexplained heartburn
• EDS often shows up through joint hypermobility, subluxations, and can be assessed using the Beighton score
• These conditions frequently overlap, requiring thorough questioning to properly identify and treat
Send in your questions by using the link in the top of the description of this podcast episode, emailing contact@endobattery.com, or visiting the endobattery.com contact page.
Website endobattery.com
Introduction to Quick Connect
Speaker 1
0:00
Life
moves
fast
and
so
should
the
answers
to
your
biggest
questions
.
Welcome
to
EndoBattery's
Quick
Connect
,
your
direct
line
to
expert
insights
Short
,
powerful
and
right
to
the
point
.
You
send
in
the
questions
,
I
bring
in
the
experts
and
in
just
five
minutes
you
get
the
knowledge
you
need
.
No
long
episodes
,
no
extra
time
needed
,
and
just
remember
expert
opinions
shared
here
are
for
general
information
and
not
for
personalized
medical
advice
.
Always
consult
your
provider
for
your
case-specific
guidance
.
Got
a
question
?
Send
it
in
and
let's
quickly
get
you
the
answers
.
Speaker 1
0:34
I'm
your
host
,
alana
,
and
it's
time
to
Dr. Spiritsos: Neurogastroenterology Expert
Speaker 1
0:37
connect
.
I'm
joined
by
my
guest
,
dr
Zachary
Spiritsos
,
a
board-certified
neurogastroenterologist
with
a
passion
for
treating
irritable
bowel
syndrome
,
functional
abdominal
pain
and
mobility
disorders
.
With
a
strong
background
in
teaching
,
research
and
patient-centered
care
,
he
brings
a
wealth
of
knowledge
and
compassion
to
the
table
.
Please
help
me
in
welcoming
Dr
Zach
Spiritos
.
Dr
Zach
Spiritos
,
talk
to
us
a
little
bit
about
what
you
see
in
symptoms
with
your
hypermobile
EDS
people
and
your
POTS
people
and
the
MCAS
people
.
What
are
the
things
that
you
see
most
in
those
patients
?
Because
I
bet
you
,
if
we
could
sit
down
and
identify
,
okay
,
these
are
some
of
our
symptoms
too
.
Here's
maybe
some
ways
we
can
address
that
.
What
do
you
typically
see
in
those
three
subsets
of
patients
?
POTS Symptoms and GI Connections
Speaker 2
1:30
Yeah
,
so
they
land
in
my
lap
.
So
I'm
a
neurogastroenterologist
,
so
I
stole
this
from
this
amazingly
smart
doctor
,
dr
Brandler
,
who's
a
neurogastroenterologist
up
in
Seattle
,
and
it's
we
are
electricians
,
not
plumbers
,
okay
.
And
so
when
patients
come
to
me
they
have
GI
symptoms
,
but
then
they
start
talking
about
other
things
that
don't
necessarily
fit
into
IBS
.
So
I
initially
,
when
I
first
graduated
and
I
was
in
practice
,
I
took
on
a
lot
of
IBS
patients
.
I
just
happened
to
love
taking
care
of
that
patient
population
.
But
then
someone
would
say
you
don't
have
IBS
.
But
all
of
a
sudden
when
I
get
up
,
my
heart
just
races
,
like
that's
not
IBS
.
I
think
an
antiquated
view
of
that
is
like
,
oh
,
you're
stressed
and
stress
causes
anxiety
and
stress
causes
palpitations
.
But
this
is
different
.
So
in
POTS
the
hallmark
feature
is
standing
up
and
just
feeling
like
your
heart
is
racing
.
Okay
,
and
with
that
I
would
say
that
brain
fog
is
a
really
big
symptom
there
.
And
then
,
kind
of
secondarily
,
some
people
get
a
lot
of
blood
pooling
in
their
feet
,
like
their
feet
get
swollen
.
But
yeah
,
certainly
the
standing
tachycardia
or
the
heart
racing
from
going
or
sitting
to
a
standing
position
is
the
hallmark
features
of
postural
orthostatic
tachycardia
syndrome
,
but
they
also
may
have
a
lot
of
GI
symptoms
getting
full
early
,
tons
of
bloating
,
loose
stools
,
conversely
constipation
.
So
the
POTS
GI
system
doesn't
really
follow
any
specific
rulebook
,
unfortunately
.
Speaker 2
3:03
Yeah
,
okay
,
so
mass
cell
activation
syndrome
is
and
of
course
this
can
be
linked
with
MCAS: Beyond Skin Manifestations
Speaker 2
3:11
POTS
too
.
So
when
I'm
talking
to
one
of
these
patients
I'm
asking
all
these
questions
,
I'm
screening
for
every
one
of
these
things
to
see
if
we
can
kind
of
piece
this
together
.
But
the
hallmark
feature
of
mass
cell
activation
syndrome
is
probably
skin
manifestations
,
so
itching
,
rashes
,
secondarily
kind
of
ears
,
nose
and
throat
issues
,
rhinorrhea
,
eyes
watering
for
,
like
,
no
good
reason
.
And
then
GI
symptoms
are
kind
of
probably
coming
third
there
and
that's
bloating
,
diarrhea
,
diarrhea
,
lots
of
heartburn
and
someone
who
,
like
shouldn't
get
heart
.
You
know
heartburn
traditionally
affects
people
who
are
,
you
know
,
a
little
bit
older
,
you
know
have
their
bmis
,
or
are
you
probably
closer
to
30
,
like
we
see
these
young
women
who
are
22
,
23
,
with
rip-roaring
heartburn
.
I'm
like
that
ain't
cured
,
it
just
doesn't
make
any
sense
and
that's
m
.
So
that's
where
.
Speaker 2
4:06
So
,
just
like
one
of
the
,
without
getting
too
into
the
nitty
gritty
of
the
pathophysiology
of
MCAS
,
but
these
mast
cells
are
just
very
twitchy
right
.
They're
intended
to
be
selectively
defensive
against
certain
pathogens
that
our
body
doesn't
like
.
Like
you
know
,
mold
If
anybody's
in
North
Carolina
like
me
just
the
pollen
is
insane
.
So
mast
cells
are
supposed
to
be
acting
up
now
,
but
these
mast
cells
become
twitchy
and
react
to
virtually
everything
,
from
temperature
changes
to
emotional
changes
,
to
poor
sleep
,
to
medications
.
It's
really
wild
,
and
one
of
the
chemicals
that
it
releases
and
it
releases
hundreds
of
chemicals
is
histamine
,
and
histamine
plays
a
big
role
in
creating
acid
secretion
from
the
stomach
which
could
lead
to
heartburn
symptoms
.
Speaker 2
4:51
But
for
all
intents
and
purposes
,
patients
don't
behave
like
traditional
gastroesophageal
reflux
patients
.
They
don't
respond
to
proton
pump
inhibitors
and
they
have
no
darn
reason
to
have
reflux
to
begin
with
.
They
don't
have
a
big
hiatal
hernia
,
which
is
a
traditional
risk
factor
for
heart
reflux
,
or
they're
not
.
You
know
they're
not
.
They're
not
overweight
,
and
so
that's
where
you
have
to
start
.
You
know
this
doesn't
quite
make
sense
,
okay
,
and
you
said
EDS
.
Speaker 1
5:17
EDS
,
this
is
a
big
one
for
us
,
okay
EDS Symptoms and Joint Mobility
Speaker 1
5:19
,
I
?
Speaker 2
5:19
have
a
lot
of
questions
for
this
one
.
Speaker 2
5:21
So
again
I
have
a
lot
of
questions
for
this
one
.
So
again
,
I'm
a
GI
doctor
so
I
deal
with
a
lot
of
the
GI
manifestations
.
But
I
certainly
screen
for
all
of
you
know
,
all
my
patients
who
I
you
know
,
who
have
MCAS
,
who
have
POTS
,
for
EDS
,
specific
symptoms
and
the
Baten
score
is
really
nice
Testing
certain
joint
mobile
hyperflexibility
.
You
know
,
being
able
to
put
both
palms
on
the
floor
with
extended
knees
.
You
know
,
are
you
able
to
bend
your
pinky
back
beyond
a
certain
angle
?
You'd
be
able
to
bend
your
thumb
beyond
a
certain
angle
and
you
can
look
up
the
bite
and
score
and
kind
of
assess
for
yourself
.
Speaker 2
5:51
But
you
know
,
did
you
have
kind
of
weird
random
joint
subluxations
as
a
kid
?
Did
your
knee
just
pop
out
of
joint
,
like
that's
not
supposed
to
happen
,
right
,
and
they're
like
oh
yeah
,
we
put
a
brace
on
it
and
kind
of
said
that
was
fine
.
I
was
like
that's
not
fine
,
like
that
doesn't
happen
.
So
you
have
to
always
ask
why
,
exactly
like
if
you're
an
exchange
,
like
if
you're
sean
white
and
doing
,
you
know
,
kick
flips
on
the
,
uh
,
on
the
,
on
the
half
pipe
,
fine
,
like
that's
,
that's
reasonable
.
But
just
like
,
yeah
,
I
was
playing
kickball
and
my
knee
just
popped
out
of
place
,
like
that's
not
a
thing
,
right
?
So
in
a
,
in
a
nutshell
,
like
a
very
condensed
,
oversimplified
way
of
kind
of
,
I
think
,
compartmentalizing
those
conditions
.
So
it's
really
important
,
you
know
,
to
really
do
a
thorough
review
of
systems
and
ask
all
the
questions
so
you
can
really
understand
why
something
happened
Episode Closing and Contact Information
Speaker 2
6:36
.
Speaker 1
6:36
That's
a
wrap
for
this
Quick
Connect
.
I
hope
today's
insights
helped
you
move
forward
with
more
clarity
and
confidence
.
Do
you
have
more
questions
?
Keep
them
coming
,
send
them
in
and
I'll
bring
you
the
expert
answers
.
You
can
send
them
in
by
using
the
link
in
the
top
of
the
description
of
this
podcast
episode
or
by
emailing
contact
at
endobatterycom
or
visiting
the
endobatterycom
contact
page
.
Until
next
time
,
keep
feeling
empowered
through
knowledge
.