Abstract
Background
There is frequent overlap between and the connective tissue diseases Joint Hypermobility Syndrome/Ehlers–Danlos Syndrome (JHS/EDS) and disorders of the gut–brain interaction (DGBIs).
Aims
Because not all JHS/EDS patients develop DGBIs, we sought to determine whether secondary environmental triggers may lead to development of irritable bowel syndrome (IBS) and functional dyspepsia (FD) in patients with JHS/EDS.
Methods
We sent electronic surveys to 253 patients from a JHS/EDS support group, with responses collected over one year. IBS and FD were diagnosed by the Rome IV criteria, with additional validated assessments of adverse childhood experiences (ACEs) and traumatic stressors according to DSM-V criteria. We compared clinical and psychological characteristics of JHS/EDS patients with and without DGBIs using univariable and multivariable analyses.
Results
We enrolled 193 JHS/EDS patients, of whom 67.9% met Rome IV criteria for IBS. The IBS and JHS/EDS overlap group reported significantly more traumatic exposures (P < 0.001) and were more likely to have experienced greater than 3 ACEs (P < 0.001) than JHS/EDS patients without IBS. FD was found in 35.2% of patients and was associated with significantly more traumatic exposures (P < 0.001) and were more likely to have experienced greater than 3 ACEs (P < 0.001) than JHS/EDS patients without FD.
Conclusions
We found that JHS/EDS patients with IBS and FD overlap reported significantly more traumatic exposures and ACEs compared to JHS/EDS patients without overlapping IBS or FD. JHS/EDS patients may have increased susceptibility to DGBIs, with traumatic life experiences and/or ACEs acting a secondary environmental trigger driving the subsequent development of DGBIs.
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Acknowledgments
The authors gratefully acknowledge Jon Rodis for his advice and efforts to promote the study to the EDS and CTD NE MA Support Group.
Disclosures
KS has received research support from Ironwood and Urovant and has served as a consultant to Anji, Ardelyx, Arena, Gelesis, GI Supply, Restalsis, and Sanofi.
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KS and CS planned and designed the study. IGF and CS collected and analyzed the data; CS drafted the manuscript; all authors interpreted the results and contributed to critical review of the manuscript. KS had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. All authors approved the final version of the article, including the authorship list.
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Silvernale, C., Garcia-Fischer, I. & Staller, K. Relationship Between Psychological Trauma and Irritable Bowel Syndrome and Functional Dyspepsia in a Joint Hypermobility Syndrome/Ehlers–Danlos Syndrome Patient Population. Dig Dis Sci 69, 870–875 (2024). https://doi.org/10.1007/s10620-023-08201-y
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DOI: https://doi.org/10.1007/s10620-023-08201-y