RH in hEDS/HSD

  • Research type

    Research Study

  • Full title

    Rectal hyposensitivity: A common pathophysiological mechanism in hypermobile Ehlers-Danlos syndrome patients with functional constipation

  • IRAS ID

    297669

  • Contact name

    Qasim Aziz

  • Contact email

    q.aziz@qmul.ac.uk

  • Sponsor organisation

    JRMO

  • Clinicaltrials.gov Identifier

    N/A, N/A

  • Duration of Study in the UK

    0 years, 2 months, 1 days

  • Research summary

    Hypermobile Ehlers-Danlos (hEDS) syndrome is associated with many bodily systems, and patients with hEDS often have many medical conditions, including those related to the gastrointestinal system. Several studies have demonstrated that patients with hEDS have a high number of gastrointestinal symptoms, particularly constipation. Studies have looked to see what may cause these symptoms in patients with hEDS, however these studies are limited by small sample sizes and the absence of control groups. Consequently it is unclear what processes may be leading to symptoms such as constipation in these patients.

    Summary of results
    Women with hEDS/HSD (hypermobile Ehlers–Danlos syndrome or hypermobility spectrum disorder) were more likely to have long-lasting constipation, especially constipation that had been going on for five years or more, compared to women without these conditions.
    They also tended to have more severe constipation symptoms, based on a standard scoring system doctors use (the Cleveland Clinic constipation score).
    However, when doctors looked at how quickly food moves through the whole gut (called “whole-gut transit”), there was no real difference between the two groups. The same was true when they looked for physical or functional problems in the rectum and pelvic floor using special imaging tests, both groups had similar rates of structural or functional abnormalities.
    The key difference was in rectal sensation. Women with hEDS/HSD were much more likely to have reduced rectal sensitivity (called rectal hyposensitivity). This means the rectum may not sense stool as well as it should, which can make it harder to feel the urge to have a bowel movement. This finding was strong and was confirmed in a second group of patients.

  • REC name

    London - Bromley Research Ethics Committee

  • REC reference

    21/PR/0628

  • Date of REC Opinion

    26 May 2021

  • REC opinion

    Further Information Favourable Opinion