- Brain and spine
There are many neurological and spinal problems which have been observed to be more common in EDS, examples include migraine, early disc degeneration, Chiari 1 malformation, craniocervical instability, motor delay, and curvature of the spine. Musculoskeletal pain can start early and be chronic. Weakness, fatigue, and mild impairment of mobility and daily activities may also occur.
- Joint problems
Some rare types of Ehlers-Danlos syndromes have severe musculoskeletal implications, such as kyphoscoliotic EDS with marked curvature and twisting of the spine and early osteoporosis. In the more common hypermobile EDS, joint problems include pain, dislocations, mild scoliosis and kyphosis, instability of the craniocervical junction at the top of the spine, Chiari 1 malformation, and a susceptibility to osteoarthritis.
- Postural tachycardia syndrome (PoTS)
Malfunctioning of the part of the nervous system that controls involuntary bodily functions (e.g. breathing, heart rate) is common with hypermobile EDS. Symptoms include fast heart rate coupled with low blood pressure, digestive and bladder problems, and temperature and sweating dysregulation. You can manage the condition by drinking more fluids, improving your cardiovascular fitness, and if your daily function is severely impaired, taking medication.
- Digestive disorders
Hypermobile Ehlers-Danlos syndrome is associated with a range of digestive disorders. These may be problems to do with the structure of the gut, such as hernias. Also common is malfunctioning of the coordination of involuntary muscle movements which push food along the digestive tract, leading to issues such as acid reflux and irritable bowel syndrome. Treatment is according to symptoms.
- Cardiovascular problems
Some rare types of EDS are characterised by cardiovascular problems - the vascular type carries a risk of arterial rupture at a young age, and in cardiac-valvular EDS there are severe progressive problems of the aortic and mitral valves. In the more common hypermobile EDS, problems that can occur are mild dilation of the aortic root (unlikely to progress and doesn't usually require treatment) and postural tachycardia syndrome. Whether there is an increased frequency of mitral valve prolapse in hEDS is controversial.
The different structure of the skin in the Ehlers-Danlos syndromes makes it more fragile than normal skin. Stretchiness, abnormal scarring, stretch marks at a young age, easy bruising and slow wound healing are all signs of EDS, but the presence and severity of these issues will depend on the type. Classical and dermatosparaxis EDS are examples of types with a lot of skin involvement, but there is some in hypermobile EDS too.
- Bladder problems
Bladder dysfunction is very common in the general population, but there may be an increased risk of various bladder disorders in EDS. This could be due to differences in the anatomy of the urinary tract and pelvis, to dysfunction of the involuntary part of the nervous system which also controls the bladder, a consequence of inflammation, or of bowel problems which can affect bladder function.
- Dental, oral and voice problems
Various types of Ehlers-Danlos syndromes can affect the teeth, gums and other oral structures. Hypermobility of the temporomandibular (jaw) joint can result in dislocations, facial and head pain.
- Mental health
Anxiety disorders and depression are commonly reported by people with hypermobile Ehlers-Danlos syndrome. There is evidence of a strong link between psychiatric problems and chronic pain in hEDS. There is some limited evidence pointing towards a connection between hEDS and other psychiatric conditions but more research is needed. Management of mental health problems can involve drug treatment and psychotherapy.
- Mast cell activation disorder
Mast cell activation disorder is a malfunctioning of part of the immune system, where a type of immune cell (mast cells) release an excess of inflammatory chemicals such as histamine, causing allergy-like symptoms throughout the body. Mast cell dysregulation may be linked to some types of Ehlers-Danlos Syndromes.