Oh my GERD or GORD!

GORD—or, GERD—depending on your location, which stands for gastro-oesophageal reflux disease. Whatever you call it, it’s when acid and other contents of the stomach reflux back up. Often this causes a burning sensation in the chest, esophagus or throat. It can cause a cough, or have no symptoms.

When it’s chronic, the acid can cause damage to your tissues or even teeth.

There’s a relationship between Ehlers-Danlos syndromes (EDS) and Joint Hypermobility Syndrome, also known as Hypermobility Spectrum Disorder and GORD.

Several studies have indicated that ~2/3 of people with EDS have GORD.1,2 It’s one of the more common digestive disorders seen with symptomatic hypermobility. We don’t know why; it may be because of mast cells, delayed motility, or related to Postural Orthostatic Tachycardia (POTS).

How to address GORD? Well, some people do have food triggers, like wine and other alcohol, chocolate, mint, tomatoes, citrus, greasy foods, carbonation or even eating too much at once or eating right before bed. People may over-restrict as a response to reflux symptoms. It’s individual, though, and it’s important not to cut out foods that don’t cause symptoms.

A few tips:

·         Have a larger gap between dinner and bedtime

·         Elevate the head of your bed—it may help with POTS, too

·         If possible, go for a short walk after meals. Even a minute or two can help

·         If possible, sleep on your left side

·         Consider supplements such as sodium alginate, zinc carnosine, fennel seed or deglycyrrhizinated licorice (DGL) if your health care team approves

If symptoms don’t respond to diet and lifestyle changes, make sure to check in with your medical team. Reflux symptoms can sometimes be a sign of eosinophilic diseases, Barrett’s esophagitis, mast cell diseases, small intestinal bacterial overgrowth and other conditions that are particularly common in people with symptomatic hypermobility.

by Cheryl Harris MPH, RD, SEDSConnective dietitian adviser

References: Quigley EMM, Noble O, Ansari U. The Suggested Relationships Between Common GI Symptoms and Joint Hypermobility, POTS, and MCAS. Gastroenterol Hepatol (N Y). 2024;20(8):479-489.

Zeitoun JD, Lefèvre JH, de Parades V, et al. Functional digestive symptoms and quality of life in patients with Ehlers-Danlos syndromes: results of a national cohort study on 134 patients. PLoS One. 2013;8(11):e80321. Published 2013 Nov 22. doi:10.1371/journal.pone.0080321

Tu Y, Abell TL, Raj SR, Mar PL. Mechanisms and management of gastrointestinal symptoms in postural orthostatic tachycardia syndrome. Neurogastroenterol Motil. 2020;32(12):e14031. doi:10.1111/nmo.14031