Gastrointestinal disorders in joint hypermobility syndrome/Ehlers‐Danlos syndrome hypermobility type: A review for the gastroenterologist

Abstract

The aim of this review was to examine the nature of GI symptoms and their underlying pathophysiology in JHS/EDS-HT. In addition, we consider the clinical implications of the diagnosis and treatment of JHS/EDS-HT for practicing clinicians in gastroenterology. Observations summarized in this review may furthermore represent the first step toward the identification of a new pathophysiological basis for a substantial subgroup of patients with functional GI disorders.

Systemic Manifestations of Ehlers-Danlos Syndrome Hypermobility Type

“…Pain and fatigue are the most common complaints in the daily clinical practice, followed by nocturnal insomnia and morning drowsiness, dysautonomia, dyslexia and neuropsychological disorders. Furthermore subjects suffer from conditions related to the restorative phases of sleep such as musculoskeletal pain, impaired concentration and cognitive deficits, which are explained, at least in part, by higher organic energy consumption [10,17,18,20,22]. In this context, there is impairment to activities of daily living, and to the professional and sports life of individuals, a situation that requires an understanding of the order of appearance and prevalence of signs and symptoms in the general population with an emphasis on this diversity of manifestations, a condition that currently suggests analyzes of signs and symptoms based on disturbances of the hyper mobile spectrum.…”

“…A thorough knowledge of gastrointestinal (GI) manifestations and their management is mandatory to avoid unnecessary morbidity and mortality [13][14][15]. An increased rate of celiac disease was identified in EDS-HT, suggestive of intestinal malabsorption, a possible factor for fatigue [16,17]. Moreover, individuals have psychiatric disorders and psychosocial impairment [18], and a high prevalence of anxiety disorders from simple phobias to panic disorders [19].…”

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“…Furthermore subjects suffer from conditions related to the restorative phases of sleep such as musculoskeletal pain, impaired concentration and cognitive deficits, which are explained, at least in part, by higher organic energy consumption. 10,17,18,20,22 In this context, there is impairment to activities of daily living, and to the professional and sports life of individuals, a situation that requires an understanding of the order of appearance and prevalence of signs and symptoms in the general population with an emphasis on this diversity of manifestations, a condition that currently suggests analyzes of signs and symptoms based on disturbances of the hyper mobile spectrum.…”

“…[13][14][15] An increased rate of celiac disease was identified in EDS-HT, suggestive of intestinal malabsorption, a possible factor for fatigue. 16,17 Moreover, individuals have psychiatric disorders and psychosocial impairment, 18 and a high prevalence of anxiety disorders from simple phobias to panic disorders. 19 The EDS-HT is characterized by pain, fatigue, proprioceptive dysfunctions, hemorrhagic syndromes, dysautonomia, dystonia and digestive tract, vesicophrectinal, respiratory, dental, otorhinolaryngological, ophthalmological, gynecological, obstetrical and cognitive disorders, among others.…”

Characterizing adolescents with heavy menstrual bleeding and generalized joint hypermobility

“…3 Potential morbidities associated with JHS, including arthralgias, developmental delay, and gastrointestinal implications, are well documented. [4][5][6][7] Additionally, patients can have easy bruising and/or bleeding due to modifications of collagen present in blood vessels. 8…”