Impact of joint hypermobility syndrome on gastric accommodation and nutrient tolerance in functional dyspepsia

Abstract

Florencia Carbone and Nick Goelen share first authorship for this work.Qasim Aziz and Jan Tack share senior authorship for this work.JT takes responsibility for the integrity of the work as a whole, from inception to published article.

Hypermobile Ehlers–Danlos syndrome and disorders of the gastrointestinal tract: What the gastroenterologist needs to know

“…In support of this, gastric MRI revealed altered motility in response to water ingestion in HSD/hEDS patients with functional dyspepsia compared with healthy controls 54 . Other studies of gastric sensorimotor function, compliance and emptying in small cohorts of patients with HSD/hEDS have otherwise revealed few specific abnormalities 14,26,29,36,43,54,55 . Similarly, colonic transit studies have also revealed no specific abnormalities in HSD/hEDS patients 14,26,36,50 …”

“…54 Other studies of gastric sensorimotor function, compliance and emptying in small cohorts of patients with HSD/hEDS have otherwise revealed few specific abnormalities. 14,26,29,36,43,54,55 Similarly, colonic transit studies have also revealed no specific abnormalities in HSD/hEDS patients. 14,26,36,50 • Visceral hypersensitivity: Direct alterations in neuronal function leading to visceral hypersensitivity have also been proposed as a contributor for symptoms in hEDS.…”

“…Because luminal wall stretch is a major stimulus to inducing pain and bloating, it might be anticipated that patients with HSD/hEDS will be more susceptible to symptom induction following gaseous distension 53 . Neither colonic compliance nor gut mechanoreceptor function in the hEDS population have been measured to test this hypothesis although no changes in gastric accommodation have been observed in HSD/hEDS studies of functional dyspepsia using MRI or intragastric barostat measures, arguing against this hypothesis 54,55 Dysmotility : Following on from the aforementioned hypothesis, altered wall compliance/elasticity and mechanoreceptor function also influences gastrointestinal motility.…”

Enrichment of Patients With Ehlers Danlos Syndrome in Idiopathic Gastroparesis—A Gene Set Enrichment Analysis

“…This is in line with the recent reports suggesting that there is a strong correlation between joint hypermobility disorders and gastrointestinal disorders ( 14 ). Several other studies documented the evidence of gastric emptying or other transit disorders in patients with EDS ( 15 , 16 ). The composition of the extracellular matrix in which the other components of the gut wall are embedded could ultimately be at the center of the pathogenesis of dysmotility ( 14 ).…”

Gastrointestinal symptoms and nutritional issues in patients with hypermobility disorders: assessment, diagnosis and management

“…Functional dyspepsia is reported in up to 50% of patients referred to secondary care with co-existent HD,4 and gastroduodenal symptoms are reported in 30% of subjects in the general population fulfilling HD criteria 8. Accelerated and delayed gastric emptying are both reported in retrospective studies7 10 while altered accommodation was not demonstrated 13 14. Mechanisms for symptoms have not been established.…”