Lam, Ching Y, Palsson, Olafur S, Whitehead, William E et al. · Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021 · DOI
This study compared stomach and digestive problems in people with hypermobility disorders (including hypermobile Ehlers-Danlos Syndrome) to a general population. Nearly all people with these hypermobility conditions (98%) had one or more functional gastrointestinal disorder, compared to less than half of the comparison group. People with hypermobility disorders also experienced many other widespread body symptoms and used healthcare services much more frequently.
Approximately 40% of this HSD/hEDS cohort reported chronic fatigue syndrome and/or fibromyalgia, highlighting substantial overlap with ME/CFS. Understanding the relationship between somatic symptom burden and GI dysfunction in hypermobility disorders may illuminate similar mechanisms in ME/CFS, where gastrointestinal complaints are common but poorly characterized.
This study does not establish causation or the specific pathophysiological mechanisms linking hypermobility to gastrointestinal dysfunction. The cross-sectional survey design cannot determine whether somatic symptoms drive FGID diagnosis or vice versa. The study also cannot definitively separate the contribution of hypermobility itself from broader systemic disease processes, as the adjustment for somatic symptoms substantially reduced associations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Lam, Ching Y, Palsson, Olafur S, Whitehead, William E, Sperber, Ami D, Tornblom, Hans, Simren, Magnus, et al. (2021). Rome IV Functional Gastrointestinal Disorders and Health Impairment in Subjects With Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome.. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. https://doi.org/10.1016/j.cgh.2020.02.034
BibTeX
@article{mecfsatlas-lam-2021-rome-functional,
author = {Lam, Ching Y and Palsson, Olafur S and Whitehead, William E and Sperber, Ami D and Tornblom, Hans and Simren, Magnus and Aziz, Imran},
title = {Rome IV Functional Gastrointestinal Disorders and Health Impairment in Subjects With Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome.},
journal = {Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association},
year = {2021},
doi = {10.1016/j.cgh.2020.02.034},
note = {PubMed: 32109633},
url = {https://www.mecfsatlas.com/evidence/lam-2021-rome-functional},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/lam-2021-rome-functional
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