{
  "abstract": "Background/objective Disorders of Gut–Brain interactions (DGBI), for example, Functional Dyspepsia (FD) or Irritable Bowel syndrome (IBS), are common in patients with hypermobile Ehlers-Danlos syndrome/hypermobile spectrum disorder (hEDS/HSD). DGBI is associated with significant healthcare use—how this applies to patients with coexisting hEDS/HSD is unknown.Design A cross-sectional study was performed. Patients recruited from tertiary neurogastroenterology clinics and from Ehlers-Danlos Support UK completed questionnaires, characterising their demographic, healthcare data and expenses, over 6 months (July 2021–January 2022) and their Rome IV diagnoses. National Health Service (NHS) unit costs were used. Healthcare use and costs were compared across and between DGBI and non-DGBI subgroups. Regression analysis was performed to determine predictors of costs. p<0.005 was considered significant.Results Median age of the 660 respondents was 39 (IQR: 29–50) years; 96.1% had a DGBI. 13.6% had IBS, 29.9% had FD, 32.1% had IBS and FD, 24.4% had neither. Patients with DGBI had high healthcare use and large healthcare costs; £3388.79/6 months, mostly attributed to consultations (36.4%) and admissions (22.7%). Costs per patient (pp) were at least double in any group with FD (£4026.53–£4297.30pp) compared with those without (£1372.49–£1979.36pp), p<0.001. The highest costs were in FD patients (>£20 000 pp/6 months). Predictors of rising costs were FD, non-gastrointestinal comorbidities, lower body mass index, positive avoidant/restrictive food intake disorders screen, having an altered diet, polypharmacy, visits to different healthcare professionals and tertiary neurogastroenterology recruitment.Conclusions It is imperative to develop cost-effective multidisciplinary services for hEDS/HSD patients with FD, particularly in the current fiscal climate, as they have significant healthcare use and costs.",
  "authors": [
    {
      "affiliations": [
        "Wingate Institute, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK"
      ],
      "name": "Advait Upadhyaya"
    },
    {
      "affiliations": [
        "Wingate Institute, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK"
      ],
      "name": "Rabia Topan"
    },
    {
      "affiliations": [
        "Wingate Institute, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK"
      ],
      "name": "Shraya Pandya"
    },
    {
      "affiliations": [
        "Department of Dietetics, Royal London Hospital for Integrated Medicine, London, UK"
      ],
      "name": "Sarah Williams"
    },
    {
      "affiliations": [
        "Gastroenterology and GI Physiology, University College London, London, UK"
      ],
      "name": "Konstantinos Fragkos"
    },
    {
      "affiliations": [
        "Gastoenterology and GI Physiology, University College London Hospitals NHS Foundation Trust, London, London, UK",
        "Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK"
      ],
      "name": "Natalia Zarate-Lopez"
    },
    {
      "affiliations": [
        "Centre for Evaluation and Methods, Queen Mary University of London, London, UK"
      ],
      "name": "Chris Roukas"
    },
    {
      "affiliations": [
        "Wolfson Institute of Population Health, Queen Mary University of London, London, UK",
        "Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK"
      ],
      "name": "Borislava Mihaylova"
    },
    {
      "affiliations": [
        "Wingate Institute, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK",
        "Gastoenterology and GI Physiology, University College London Hospitals NHS Foundation Trust, London, London, UK"
      ],
      "name": "Asma Fikree"
    }
  ],
  "title": "Healthcare utilisation and healthcare costs for patients with hypermobile spectrum disorders and coexisting functional dyspepsia and/or irritable bowel syndrome",
  "uid": "338760be-b738-57e4-b763-6e12dc3a9271"
}