Successful Treatment of a Patient with Hypermobile Ehlers-Danlos Syndrome with Gastrointestinal Complications Through Personalised Artificial Nutrition: A Case Report

An increasing number of studies are highlighting gastrointestinal disorders associated with hypermobile Ehlers-Danlos syndrome (hEDS), particularly in cases where it is accompanied by postural orthostatic tachycardia syndrome and mast cell activation syndrome. The diagnosis of these conditions remains challenging. Gastrointestinal symptoms include chronic small intestinal dysmotility and visceral hypersensitivity. Here, the authors present the case of a young woman with hEDS, postural orthostatic tachycardia syndrome, and mast cell activation syndrome, whose quality of life improved significantly after she started receiving artificial nutrition. This case is of particular interest as, during the initial phase of parenteral nutrition, several central vascular accesses failed prematurely due to an abnormal subcutaneous fibrinoid reaction. Switching to enteral nutrition was crucial in resolving the complications associated with a central venous access, restoring intestinal function, and improving quality of life. This paper will examine the challenges presented by this case in detail, providing notes on the necessary pathophysiology to understand the gastrointestinal complications related to hEDS and evaluating the most effective and sustainable medical and nutritional strategies.