1. Ehlers Danlos Syndrome

2. Ehlers Danlos Syndrome
Group of inherited connective tissue disorders mostly affecting collagen production
Defined by hyperextensible joints and elastic skin
First described by Hippocrates in 400 BC
10 recognized types
Most common are inherited by Autosomal Dominant mechanism
Clinical diagnosis by Breighton Score

3. Breighton Score

4. EDS GI Involvement Worst with EDS Type IV (Collagen III)
Main supportive constituent of bowel and vasculature
Can also be in Types I, II, III (Collagen V and I)
Mucosa, Submucosa, Serosa involvement
20% higher GI symptoms than in matched controls

5. Breakdown of gums and premature loss of teeth (type VIII)
Subluxation of Temporo-mandibular joint

6. Hiatal hernia
Megaesophagus
Esophageal rupture with vomiting
GERD

7. Peptic Ulcer Disease

8. Functional GI Pain
Dysmotility
IBD
Malabsorption
Volvulus
Diverticulosis (Stomach, Gallbladder, Intestines)
Perforations of Small & Large Intestines
Vascular issues: Aneurysms (AAA), Rupture, Dissection, Varicosities, Arteriovenous Fistulas

9. Avoid fecal impaction with strict bowel regimens! Don’t use Enemas!
Rectal Prolapse
Hemorrhoidal Bleeds
Chronic Constipation