EDS and Gut Health: The Role of the Microbiome

If you live with Ehlers-Danlos Syndrome (EDS), gut issues aren’t just an occasional bother—they’re a daily struggle. Research shows that up to 84% of people with EDS deal with chronic digestive problems like nausea, bloating, and unpredictable bowel movements. Why? The answer lies in collagen, the structural protein that holds our connective tissues together—including those in the gut. When collagen is faulty, the gut can’t function properly, leading to a range of digestive challenges.

But there’s another key player in this story: the gut microbiome. This vast community of bacteria, viruses, and fungi living in our intestines helps regulate digestion, immunity, and even mood. In EDS, an imbalanced microbiome (also called dysbiosis) may worsen symptoms by triggering inflammation, nerve hypersensitivity, and poor gut motility. Additionally, many EDS patients have Mast Cell Activation Syndrome (MCAS), Postural Orthostatic Tachycardia Syndrome (POTS), and Small Intestinal Bacterial Overgrowth (SIBO), which further complicate gut health. Let’s explore how EDS affects digestion and what you can do to support your microbiome.

How EDS Disrupts Gut Function

EDS impacts digestion in several ways, largely due to weakened connective tissues and nerve dysfunction. Here’s how:

Slow or Fast Gut Motility: The gut relies on rhythmic muscle contractions (peristalsis) to move food along. Weak connective tissue in EDS can slow this process (causing constipation) or speed it up (leading to diarrhea).
Gut Nerve Sensitivity: Many people with EDS experience visceral hypersensitivity, where normal digestion feels painful due to overactive gut nerves.
Leaky Gut & Inflammation: The gut lining acts as a barrier, letting nutrients in while keeping harmful substances out. In EDS, collagen defects may weaken this barrier, allowing toxins and bacteria to enter the bloodstream and trigger inflammation.
Microbiome Imbalance & MCAS: Research suggests that EDS may be linked to gut dysbiosis—an imbalance of good and bad bacteria that can worsen bloating, pain, and immune dysfunction. MCAS can further aggravate these symptoms by increasing histamine release, leading to food sensitivities and digestive distress.

Common Symptoms & Related Conditions

Nausea & Vomiting: May be linked to slow digestion, migraines, or nervous system dysfunction.
Bloating & Reflux: Weak stomach muscles can trap gas and delay emptying, causing discomfort.
Constipation & Diarrhea: Unpredictable motility can cause frustrating cycles.
Food Sensitivities & Histamine Intolerance: Many EDS patients react poorly to high-histamine foods due to MCAS.
Malabsorption & Nutrient Deficiencies: Poor digestion can lead to low levels of iron, B12, and magnesium.

Many EDS patients are also diagnosed with conditions like Irritable Bowel Syndrome (IBS), Gastroesophageal Reflux Disease (GERD), Postural Orthostatic Tachycardia Syndrome (POTS), Small Intestinal Bacterial Overgrowth (SIBO), and Mast Cell Activation Syndrome (MCAS)—all of which can impact gut health.

How to Support Your Gut & Microbiome

While there’s no one-size-fits-all approach, these strategies can help manage EDS-related gut issues:

1. Feed Your Microbiome

Eat Prebiotics: Foods like bananas, oats, and asparagus feed beneficial gut bacteria.
Try Probiotics (With Caution): Some EDS patients benefit from probiotics, especially strains like Bifidobacterium infantis. However, those with SIBO or MCAS may experience bloating or reactions, so start slowly.
Fermented Foods (With Caution): While foods like kefir, yogurt, kimchi, and sauerkraut contain probiotics that support gut health, they are also high in histamines. Since many people with EDS also have MCAS, fermented foods may trigger symptoms in some individuals. It's best to introduce them gradually and monitor your body's response.

2. Support Gut Motility

Hydration: Drink plenty of water to keep digestion moving.
Gentle Fiber Intake: Soluble fiber (like chia seeds and cooked vegetables) is easier to tolerate than raw veggies.
Prokinetics (If Needed): Medications like low-dose erythromycin or prucalopride can help speed up sluggish digestion.
Electrolyte Balance: Proper sodium and magnesium intake can support motility, especially for those with POTS.

3. Reduce Gut Inflammation

Limit Processed Foods: Artificial additives and high-sugar diets can worsen dysbiosis.
Manage Histamines: If you have MCAS, reducing high-histamine foods (like aged cheese and processed meats) may help.
Consider L-Glutamine & Quercetin: L-Glutamine may help repair the gut lining, while quercetin acts as a natural mast cell stabilizer.

4. Calm Your Nervous System

Stress Management: The gut-brain connection is real—high stress can trigger symptoms.
Gentle Movement & Vagus Nerve Stimulation: Practices like EDS movement therapy, deep-breathing, moving meditation, and exercises customized to EDS body needs can reduce stress and enhance symptoms.
Personalized Support with ParaMotion: Check our ParaMotion YouTube Channel for movement recommendations, or book a consultation with us to receive personalized help tailored to your body's needs.

When to Seek Help

While many gut symptoms in EDS can be managed with lifestyle changes, some require medical attention. See a doctor if you experience:

Unexplained weight loss
Blood in stool or vomit
Severe, persistent pain

Looking Ahead: The Future of Gut Health in EDS

Research into the EDS-microbiome connection is still evolving. Scientists are exploring:

How gut bacteria influence connective tissue health
Whether targeted probiotics could improve symptoms
The role of serotonin (a key gut neurotransmitter) in EDS-related motility disorders
New treatments for MCAS and SIBO in EDS patients

By staying informed and working with EDS-aware healthcare providers, you can take proactive steps to improve your gut health and overall well-being.

Key Takeaways

EDS affects gut function through weak connective tissue, nerve sensitivity, microbiome imbalances, and comorbidities like MCAS and SIBO.
Supporting gut health involves eating microbiome-friendly foods, staying hydrated, managing histamines, and reducing stress.
Emerging research may offer new treatment options for EDS-related gut issues in the future.

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