By Kristin Kennedy, PT, DPT
If you’ve been diagnosed with hypermobility or hypermobile Ehlers-Danlos syndrome (hEDS), you might have experienced more than just joint pain and instability. For many people with hypermobility, gut issues—such as bloating, abdominal pain, and altered bowel habits—are a frustrating reality that goes hand-in-hand with their condition.
But what exactly is the connection between hypermobility and digestive issues? And how can you manage these overlapping challenges? In this blog, we’ll explore the science behind this connection and offer some strategies to help improve gut health.
The Overlap Between Hypermobility and Digestive Issues
It may seem surprising that a condition affecting the joints could impact the digestive system, but emerging research shows that individuals with hypermobility, particularly hEDS, are more prone to gastrointestinal (GI) symptoms. Some of the most common gut issues reported include:
Gastroesophageal reflux disease (GERD): Acid reflux and heartburn can be persistent problems.
Irritable bowel syndrome (IBS): A common condition involving cramping, bloating, gas, and diarrhea or constipation.
Gastroparesis: A condition where the stomach takes longer than usual to empty its contents into the small intestine, leading to nausea, bloating, and discomfort.
So why do people with hypermobility experience these GI issues? Keep reading!
The Role of Connective Tissue and Its Effects on Digestion
Hypermobility stems from defects in connective tissue—the proteins that give our skin, ligaments, and organs structure and elasticity. Because connective tissue is present throughout the entire body, including the gut, issues with connective tissue can affect how the gastrointestinal system functions.
In hEDS, the gut walls may be more lax and less able to properly contract and move food along the digestive tract. This can result in slower digestion, leading to bloating and gastroparesis, or it might cause hypersensitivity, which is often seen in IBS.
Autonomic Nervous System Dysfunction and How It Can Affect Digestion
Another factor that links hypermobility and gut issues is autonomic dysfunction, which you may know as dysautonomia. The autonomic nervous system controls involuntary bodily functions, including digestion, heart rate, and blood pressure. Many people with hypermobility syndromes also have autonomic dysfunction, which can affect how well the gut operates.
For example, blood flow to the digestive tract can be impaired, and the nerves that regulate gut motility may be underactive, contributing to symptoms like constipation or slow gastric emptying.
Mast Cell Activation Syndrome (MCAS)
MCAS is another condition often seen in people with hypermobility. Mast cells are part of the immune system and help protect the body from pathogens. However, in MCAS, these cells are overly reactive, releasing histamine and other chemicals that can lead to inflammation.
In the gut, mast cell activation can cause a range of problems, including diarrhea, abdominal pain, and food intolerances. This may explain why so many people with hypermobility also have food sensitivities or experience GI discomfort after eating.
Managing Digestive Symptoms in Hypermobility
While there’s no one-size-fits-all approach to managing gut symptoms in hypermobility, several strategies can help alleviate discomfort and improve overall digestion.
Dietary Adjustments
Low FODMAP Diet: This diet reduces certain carbohydrates that are poorly absorbed by the gut and can trigger IBS symptoms like gas and bloating. Many people with hEDS and GI issues find relief from a low FODMAP approach. However, some people have difficulty maintaining this diet for an extended period.
Anti-Inflammatory Diet: Incorporating anti-inflammatory foods - such as leafy greens, fatty fish, and fruits - may help calm inflammation in the gut.
Small, Frequent Meals: Eating smaller meals throughout the day can help avoid overwhelming the digestive system, especially for those with gastroparesis.
Physical Therapy and Movement
Gentle exercises, like yoga or swimming, can improve gut motility by encouraging movement within the intestines. Core stabilization exercises can also help support digestive health by improving overall body function.
Stress Management
Since the gut-brain axis plays a role in digestion, managing stress through techniques such as mindfulness, meditation, or cognitive-behavioral therapy (CBT) can improve gut function. Many people with hypermobility find that reducing stress helps alleviate GI symptoms.
Medication and Supplements
In some cases, medications like proton pump inhibitors (for GERD) or prokinetics (for gastroparesis) may be necessary to manage symptoms.
Supplements such as digestive enzymes or probiotics may also support gut health, though it’s important to consult with a healthcare provider before starting any new supplements.
Pelvic Health Physical Therapy
For individuals experiencing GI issues related to pelvic floor dysfunction, working with a pelvic health physical therapist may provide relief. Pelvic floor PT can help address issues like constipation and fecal incontinence by improving muscle coordination.
If you have hypermobility or hEDS and struggle with gut issues, know that you’re not alone. The connection between these conditions is becoming more widely recognized, and there are ways to manage and improve your symptoms. By focusing on diet, lifestyle changes, and medical support, you can take steps toward better digestive health.
At Wellest, we specialize in treating people with hypermobility and associated conditions like GI issues. If you’d like personalized support to manage your symptoms, contact us to schedule a consultation.
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