{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:51:08Z","timestamp":1790603468483,"version":"4.1.0"},"reference-count":91,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007469","name":"Alfred Benzon Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007469","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Hypermobile Ehlers\u2013Danlos syndrome (hEDS) and the hypermobility spectrum disorders (HSD) can be challenging to diagnose and manage. Gastrointestinal symptoms and disorders of gut\u2010brain interaction are common in this cohort and multifactorial in origin. The primary aim of this review is to arm the gastroenterologist with a clinically useful understanding of HSD\/hEDS, by exploring the association of gastrointestinal disorders with HSD\/hEDS, highlighting current pathophysiological understanding and providing a pragmatic approach to managing these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Literature relevant to the gastrointestinal system and hypermobile Ehlers\u2013Danlos syndrome was systematically searched, critically appraised, and summarized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diagnosis is based upon clinical criteria and a genetic basis is yet to be defined. The prevalence of many gut symptoms, including abdominal pain (69%\n                      <jats:italic>vs<\/jats:italic>\n                      27%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001), postprandial fullness (34%\n                      <jats:italic>vs<\/jats:italic>\n                      16%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01), constipation (73%\n                      <jats:italic>vs<\/jats:italic>\n                      16%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and diarrhea (47%\n                      <jats:italic>vs<\/jats:italic>\n                      9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) are significantly higher in HSD\/hEDS compared with non\u2010HSD\/hEDS individuals. Disorders of gut\u2010brain interaction are also common, particularly functional dyspepsia. The pathophysiology of gut symptoms is poorly understood but may involve effects of connective tissue laxity and its functional consequences, and the influence of autonomic dysfunction, medication and comorbid mental health disorders. Awareness is the key to early diagnosis. Management is limited in evidence\u2010base but ideally should include an integrated multidisciplinary approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HSD\/hEDS is a multisystemic disorder in which gastrointestinal symptoms, particularly related to disorders of gut\u2010brain interaction are common. Deficiencies in knowledge regarding the pathophysiological processes limit evidence\u2010based interventions and remain important areas for future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.15927","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T21:05:53Z","timestamp":1656104753000},"page":"1693-1709","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Hypermobile Ehlers\u2013Danlos syndrome and disorders of the gastrointestinal tract: What the gastroenterologist needs to know"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5250-2086","authenticated-orcid":false,"given":"Phoebe A","family":"Thwaites","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-1712","authenticated-orcid":false,"given":"Peter R","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca E","family":"Burgell","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Central Clinical School Monash University and Alfred Health Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19980428)77:1<31::AID-AJMG8>3.0.CO;2-O"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31538"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33231"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.01.014"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.02.034"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0194-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31552"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/cge.14026"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.32.5.413"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1742-1241.2003.tb10455.x","article-title":"A simple questionnaire to detect hypermobility: an adjunct to the assessment of patients with diffuse musculoskeletal pain","volume":"57","author":"Hakim AJ","year":"2003","journal-title":"Int. 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