{
  "abstract": "Introduction Hypermobile Ehlers Danlos Syndrome (hEDS) is a non-inflammatory connective tissue disorder, associated with a high prevalence of gastrointestinal (GI) symptoms, including dyspepsia/gastroparesis type symptoms. Previous studies demonstrate that hEDS patients attending GI clinics do not have an increased prevalence of colonic, small bowel or oesophageal motility compared to non-hypermobile counterparts. In view of the high prevalence of dyspepsia we sought to determine whether there are any differences in early or late gastric emptying or gastric morphology compared to non-hypermobile patients.Methods Retrospective observational study in consecutive patients referred from a neurogastroenterology clinic for gastric emptying studies between 2013 and 2023. Gastric emptying parameters and gastric morphology were compared in patients with and without hEDS. Patients on opioids, liquid meals and without available 4-hour study data were excluded. Delayed gastric emptying was defined as >60% at 2 hours or >10% at 4 hours. Early-stage (0-1hr) and late-stage (1-4hr) gradients of the retention-time data were calculated to examine early vs late gastric emptying. Gastric morphology was assessed by 4 blinded raters reaching consensus on the predominant morphology across the 0,1,2 and 4hr images according to a published 4-shape classification (Lee et al., 2024).Results 440 patients underwent gastric emptying over the time period- 344 were excluded leaving 96 patients - 28 (29%) with hEDS and 68 (71%) without. There was no significant difference in the prevalence of delayed gastric emptying in patients with hEDS (57%) compared to non-hEDS (50%, p=0.52), nor any difference in early (p=0.89) or late (p=0.53) stage gradients (Fig 1). In hEDS patients, the most common gastric morphology was Crescentic (63.0%), followed by J-shaped (18.5%), Cylindrical (7.4%), Bag-Like (7.4%) and Reverse-L (3.7%). No significant difference was observed in the distribution of any gastric morphology between hEDS and non-hEDS patients (all p>0.05).Conclusions Absolute gastric emptying, early and late stage emptying patterns, and gastric morphology do not differ significantly between hEDS and non-hEDS patients. This supports the current literature in other parts of the GI tract suggesting that hEDS patients are not at increased risk of gastric dysmotility compared to their non hypermobile counterparts.Reference Lee SO, Arwani R, McNeilly S, Kunkel S, Dadparvar S, Maurer AH, Parkman HP. Variation of stomach shapes in gastric emptying scintigraphy: correlation with gastric emptying results, body weight, and symptoms. Neurogastroenterology & Motility 2024;37(2). https://doi.org/10.1111/nmo.14968.Abstract FP48 Figure 1Early and late-stage gradients for both groups",
  "authors": [
    {
      "affiliations": [
        "GI Physiology Unit, University College Hospital NHS Trust, London, UK"
      ],
      "name": "Enrico Palma"
    },
    {
      "affiliations": [
        "Institute of Nuclear Medicine, University College Hospital NHS Trust, London, UK"
      ],
      "name": "Jamshed Bomanji"
    },
    {
      "affiliations": [
        "GI Physiology Unit, University College Hospital NHS Trust, London, UK"
      ],
      "name": "Natalia Zarate-Lopez"
    },
    {
      "affiliations": [
        "GI Physiology Unit, University College Hospital NHS Trust, London, UK"
      ],
      "name": "James Endersby"
    },
    {
      "affiliations": [
        "GI Physiology Unit, University College Hospital NHS Trust, London, UK"
      ],
      "name": "Asma Fikree"
    }
  ],
  "title": "FP48 Evaluating early and late gastric emptying and gastric morphology in patients with and without hypermobile ehlers-danlos syndrome",
  "uid": "860bd1ad-12a2-5ffd-a53e-5b924647f79c"
}