• arielaaviva

EDS Conference: GI symptoms

Because your GI tract is made primarily from connective tissue, EDS can cause a number of GI symptoms.

Dr. Qassim Aziz's talk on GI complications

slides here

  • as many nerves in the gut as in spinal cord

  • interactions between nerves and collagen

  • 3 main problems: mechanical, sensitive gut, leaky gut

Mechanical problems:

  • "tap water vs hose" -- too stretchy = slows the flow

  • weak nerves and muscles in gut (+ poor coordination) → also, when too floppy, nerves can get damaged and/or over-sensitive

Mechanical problem symptoms:

  • Reflux (and feels more intense than other people -- HSP?)

  • Swallowing problems

  • functional dyspepsia **50% of patients with functional dyspepsia meet criteria for hEDS

  • Sharp stomach pain, tightness, nausea, some vomiting, MUCH bloating

  • Slow or rapid emptying of stomach (often with POTS)

  • Constipation from not moving correctly

  • Pelvic floor issues (rectocele more common in hEDS)

  • Stagnation, sluggish gut, unhealthy bacteria fermentation → flatulence and small intestine bacterial overgrowth

Sensitive gut:

  • Sensitization of nerves in esophagus, gut, spine

  • Anterior abdominal wall pain -- trigger points in the ab muscles, can be triggered by movement or gut activity, etc, cutaneous nerves trapped → burning pain (treatable)

Leaky gut:

  • intestinal barrier dysfunction, mast cell activation, etc

  • Diarrhea, gas, pain, etc

POTS and gut issues:

  • tired, dizzy, drowsy, have to lie down after meals

  • Because of blood flow to gut?

  • Rapid stomach emptying, especially carbs/sugars → osmosis issues from too much fluid dumped at once?

  • limit liquids before/after meals, lie down for 30 mins after, increase fat/protein, be mindful of glycemic index

Other thoughts:

  • Empathy and reassurance from physicians is so important, and explanation

  • Overlap with IBD, celiac, AI CTD

  • Not solved by x-rays or structural investigation -- more sensitivity tests

  • Avoid opioids

  • Get psych and other physicians involved who know/believe EDS

  • Often FODMAP issues, and low-histamine diet for MCAS

  • Developing a diet for hEDS patients with gut issues!

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