29/07/2025
A new clinical update from the American Gastroenterological Association offers practical guidance for managing gastrointestinal symptoms in people with:
🦓Hypermobile Ehlers-Danlos syndrome (hEDS)
🦓Hypermobility spectrum disorders (HSDs)
💙Postural Orthostatic Tachycardia Syndrome (POTS)
💜Mast Cell Activation Syndrome (MCAS)
These conditions often overlap, and many people experience chronic gut issues like nausea, bloating, reflux, diarrhoea, or constipation, which are symptoms frequently linked to disorders of gut-brain interaction (DGBI), such as IBS or gastroparesis.
Key takeaways from the update:
🔎 Screening matters: Gastroenterologists should ask about joint hypermobility and consider using the Beighton Score to screen for hEDS/HSDs, especially in patients with persistent DGBI symptoms.
💉 Testing should be targeted: Routine testing for POTS or MCAS isn’t recommended unless symptoms strongly suggest it (e.g., multisystem flares, orthostatic intolerance, or episodic rashes and flushing).
🧠 Multisystem thinking is essential: GI issues in these conditions often link to autonomic and immune dysfunction. Managing POTS or MCAS may improve gut symptoms.
🧂 Management is symptom-based: Focus on hydration, pacing, diet (tailored and supported by a dietitian), pelvic floor rehab, compression wear, and select GI meds.
👩⚕️ A multidisciplinary team helps: Collaboration with cardiology, neurology, allergy, psychology, exercise physiology, dietetics and more is often needed.
This update is a big step toward validating what many already know: the gut doesn’t act alone. Multisystem symptoms require a multisystem lens, as well as compassionate and coordinated care.
📄 Read the full article here https://www.sciencedirect.com/science/article/pii/S1542356525003180
