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Gastrointestinal and eating problems in women with Ehlers–Danlos syndromes



Ehlers–Danlos syndromes (EDS) are a group of heritable conditions in which abnormal collagen synthesis leads to features such as joint hypermobility, skin abnormalities, and tissue fragility. Gastrointestinal (GI) symptoms are common among those affected. These may negatively impact eating behaviors, leading to weight/nutritional problems. We aimed to compare GI symptoms, disordered eating, and body mass index (BMI) between EDS patients and healthy controls, and to explore the link between these variables in EDS patients.


In this cross-sectional study, women with EDS and healthy controls responded to an online survey assessing GI symptoms (heartburn/regurgitations, early satiety, nausea/vomiting, bloating, abdominal pain, dysphagia), food allergies/intolerances, disordered eating, history of eating disorders (ED), and BMI. We performed intergroup comparisons as well as multivariate analyses to explore the associations between disordered eating, GI symptoms, and BMI in the EDS group.


Sixty-six women with EDS and 39 healthy controls were included in the study. The EDS patients showed significantly more GI symptoms and food allergies/intolerances, increased prevalence of ED history, higher risk of current ED, and lower BMI than the controls. In the EDS group, the risk for ED was associated with GI symptoms; restricted eating was associated with GI symptoms, food allergies/intolerances, and dysphagia; uncontrolled eating was associated with GI symptoms; and BMI was associated with GI symptoms and food allergies/intolerances.


Our results are concordant with that of previous reports highlighting the high level of GI problems and disordered eating in women with EDS. In addition, and for the first-time, the association between both is evidenced in this specific population.

Level of evidence III

Case-control analytic study.

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Fig. 1

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.


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The authors wish to thank all the participants of this study, Josefa Lopez, Susan Cuéllar, Eva Angelina Fernandez and Magdalena Pérez for their time and valuable collaboration.


This research did not receive any Specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information




CBV and PE designed the study. CBV, PE and ETV collected the data. ETV contributed with data management. SL performed the statistical analysis. CBV drafted the manuscript, and PE, ETV, SL, MSM and SG critically revised the draft for important intellectual content. All authors agreed on the final version.

Corresponding author

Correspondence to Carolina Baeza-Velasco.

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The authors have no conflict of interest to disclose.

Ethics Approval

Ethical approval was obtained from the Comissió d’Ètica en l’Experimentació Animal i Humana (CEEAH) of the University Autonomous of Barcelona in September 2019 (Registration number ID CEEAH 4799).

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All participants gave their written consent at the beginning of the online survey.

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Baeza-Velasco, C., Lorente, S., Tasa-Vinyals, E. et al. Gastrointestinal and eating problems in women with Ehlers–Danlos syndromes. Eat Weight Disord (2021).

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  • Ehlers–Danlos syndrome
  • Joint hypermobility
  • Gastrointestinal problems
  • Disordered eating
  • Food allergies
  • BMI