Hypermobility, Neurodivergence and the GUT
Both Hypermobility Ehlers-Danlos syndrome (hEDS) & Hypermobility spectrum disorders (HSD) are associated with digestive issues. Connective tissue is present throughout the body including in the digestive tract.
Connective tissue is essential for passive mechanical movements needed to complete digestion. For example connective tissues are vital in the performance of peristalsis, which is the movement needed in the bowel to expel waste from the body. Abnormalities in connective tissues may alter gut function, digestion and absorption of nutrients.
Connective tissue is also present around the nerves of the digestive tract and abnormalities of this can potentially make the gut more sensitive causing increased pain or discomfort.
Common digestive symptoms associated with hEDS and HSD include
Fast or slow gut motility
Gut microbiome dysbiosis
Acid reflux and heartburn
Nausea, bloating
Appetite changes
Constipation & diarrhoea
Food sensitivities and intolerances
Mast cell activation syndrome (MCAS) & Histamine intolerance
Irritable Bowel Syndrome (IBS)
and more
So why is this important to understand?
Both HSD and hEDS can frequently co-occur with Neurodivergence. While research is limited, it is beginning to link Neurodivergence and hypermobility more.
-Individuals with EDS are 7.4 times more likely to be autistic.
-In one 2022 study of Neurodivergent individuals, 51% had hypermobility compared to 17.5% in the non-neurodivergent comparison population.
-In a case control comparison there was a statistically significant relationship between Autism and Generalized Joint Hypermobility.
Lets link how hypermobility impacts Neurodivergent individuals
Autistic individuals frequently have sensory processing differences, and EDS may compound the effects upon the sensory system, including a general hyposensitivity to proprioceptive input (feedback from muscles and joints) impacting eating and feeding.
Increased sensitivity in the gut may also impact appetite and digestive comfort making eating difficult.
Hypermobility might impact the digestive system by causing gastrointestinal dysmotility, leading to symptoms like acid reflux, slow or fast stomach emptying, constipation, diarrhoea and abdominal pain. This may cause changes in appetite, hunger and ability to eat, and may create fear or anxiety around food and bodily functions.
Connective tissue fragility may result in hernias, diverticulosis and exacerbate digestive issues complicating nutrient absorption leading to malnutrition.
Hypermobility may cause weakened connective tissues of the esophagus and throat. This can lead to difficulties coordinating the muscles needed for swallowing, resulting in difficulty swallowing, frequent choking, and an increased risk of aspiration. This may increase fear and anxiety around food and eating, potentially leading to ARFID.
Written by Margo White, your Melbourne-based neurodiversity affirming clinical nutritionist and Neurodivergent advocate.
References
https://www.ehlers-danlos.org/research/
https://onlinelibrary.wiley.com/doi/10.1111/nmo.13013
https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00656/full
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8847158/
This article is intended as general advice only and does not replace medical advice. It is recommended that you seek personalised advice specific to your individual needs.
