Comorbidities & Symptoms

It is well-established that Ehlers-Danlos Syndrome (EDS) frequently coexists with a variety of other health conditions (i.e., comorbidities) that cause a wide range of symptoms (Leganger et al., 2022). A variety of gastrointestinal abnormalities and autonomic dysfunction (also known as dysautonomia) are common comorbidities (Alomari et al., 2020; Do et al., 2021).

While research on the use of diet to treat EDS itself is currently limited, there is growing research on the use of diet to alleviate symptoms associated with the previously stated comorbidities (Do et al., 2021). As a result, we aim to educate people with EDS about these common comorbidities and the evidence-based dietary modifications in order to help them manage their overall health better.

Gastrointestinal Abnormalities

Alomari et al. (2020) describes Ehlers-Danlos Syndrome (EDS) as a disorder of connective tissue, which is located all throughout the body. As a result, EDS can affect a variety of bodily systems and organs (Alomari et al., 2020). In particular, Alomari et al. (2020) states that the gastrointestinal (GI) tract of the digestive system is affected both structurally and functionally.

According to Nelson et al. (2015), there is a strong link between EDS, especially the hypermobile type, with various GI symptoms. They found that the most common GI symptoms include abdominal pain, nausea, constipation, heartburn, and irritable bowel syndrome symptoms. Among the symptoms mentioned, abdominal pain has been shown to be the most common symptom across all EDS subtypes (Nelson et al., 2015).

EDS is also strongly linked to functional gastrointestinal disorders (FGIDs) (Beckers et al., 2017), which are recurring gastrointestinal signs and symptoms that do not involve structural or chemical changes in the body (de Bortoli et al., 2018). In fact, a large study of 603 EDS patients conducted by Lam et al. (2021) discovered that 98 percent of participants had at least one FGID.

Among the various types of FGIDs, Lam et al. (2021) found that irritable bowel syndrome and functional dyspepsia were the most common. Both of these conditions have overlapping symptoms and may exist simultaneously (Wang & Fang, 2021).

Individually, IBS is characterized as recurrent abdominal pain with altered bowel habits, including constipation and diarrhea (Nordin et al., 2022). Meanwhile, functional dyspepsia, also known as indigestion, is a condition that involves upper abdomen pain or discomfort related to meals, and often includes early satiety (feeling full quickly) and postprandial fullness (feeling excessively full after eating) (Potter et al., 2020).

Autonomic Dysfunction (Dysautonomia)

The autonomic nervous system controls bodily functions that are automatic or involuntary, such as heart rate, digestion, blood pressure, breathing, internal temperature, eye movement, and urine flow (Sánchez-Manso et al., 2022). While autonomic dysfunction disorders can be inherited, they can also be caused by medications, infections, spinal cord injuries, and diseases that affect the body's metabolic functions (Sánchez-Manso et al., 2022).

(Sick Woman Having Stomach Ache Abdomen Stock Photo 696568864, n.d.)

(Postural Orthostatic Tachycardia Syndrome Pots Intolerance [Stock Vector] 1319209700, n.d.)

Heart palpitations (pounding of the heart), cardiovascular syncope (temporary loss of consciousness), and dizziness are common types of autonomic dysfunction experienced by people with Ehlers-Danlos Syndrome (EDS) (Song et al., 2021). Furthermore, postural orthostatic tachycardia syndrome (POTS) has been identified in a significant number of EDS patients, particularly those with hypermobile EDS (Fedorowski, 2019; Grigoriou et al., 2015).

POTS is a type of cardiovascular autonomic dysfunction characterized by a fast heart rate that slows when the patient is in a reclined position. Lightheadedness, fatigue, esophageal hypomobility (irregular digestive contractions), fainting, headaches, brain fog, tremors, and nausea may accompany these rapid changes in heart rate (Riley, 2020; Fedorowski, 2019; Grigoriou et al., 2015).

While the exact cause of POTS in people with hypermobile EDS is unknown, a potential explanation involves the elevated catecholamine (hormones responsible for the "fight or flight" response) and histamine (chemical released in the presence of potential allergens or debris) levels observed in some individuals with hypermobile EDS and POTS (Riley, 2020).