Frequently EDS and POTS occur together in the same patient. When combined, patients may experience greater weakening of valves and walls of veins leading to even greater venous pooling of blood into the lower body. Over-stretched and dilated veins encourage more exaggerated venous pooling. Thus, they share POTS symptoms like headache, dizziness and “brain fog,” only they tend to be more severe. Further reduction in cardiac output leads to greater abdominal and more severe general POTS symptoms. Like POTS, EDS mostly affects females.  A variety of genetic abnormalities have been discovered to be responsible for EDS. More recently, EDS is being referred to as the Joint Hypermobility Syndrome (JHS).

EDS (Ehlers-Danlos Syndrome) is a group of inherited disorders that affect the structure of collagens (the connective tissues) that support most body parts – primarily skin, eyes, mucous membranes, nerves, vascular, cardiac, joint and bone structures. Lack of collagen coverings can result in bluish-purple discoloration white of eyes, mouth and teeth.

EDS occurs frequently in the general population and like POTS occurs most frequently among females. EDS appears to be a dominant hereditary trait, meaning if only one parent transmits the gene to you, you will manifest some of its characteristics. In EDS patients, the connective tissue structures are defective and weakened. Connective tissues come in many specialized forms and serve to support, strengthen, bind and maintain the shapes of all organs.

The most common physical manifestations of EDS are thin hyper-elastic skin (excessive skin stretching), easy bruising, bleeding, poor wound healing and joint hypermobility. All joints can be affected; looseness and “double-jointedness” are characteristic of EDS and can be observed in the fingers, wrists, shoulders, elbows, back, knees and toes. Joints that are extremely loose (double-jointed) are more prone to recurrent sprains. Because of weakened joint structure, EDS patients are more prone to repetitive stress injuries, ligament and cartilage tears, dislocations, joint pains and chronic arthritis.

A majority of EDS patients also exhibit gastrointestinal symptoms such as upper abdominal pain, gastro-intestinal reflux, early feeling of fullness, and disturbances of intestinal motility (nausea, bloating and vomiting). Lower abdominal symptoms include diarrhea and constipation. Defective collagen within the blood vessels and walls of the intestines alters their function – reducing muscular contractibility and slowing motility.

The weakness of the tissues and muscles that strengthen the abdominal wall result in an increase in abdominal and inguinal (groin) hernias (tears in the supportive tissues of the abdominal wall). Defective collagen within the pelvic organs results in loss of pelvic support and abnormalities of bladder function, especially in women.

Every patient with EDS needs to be evaluated by a cardiologist to rule out the presence of abnormalities of heart valves and major vessels.

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