LAUSR

Abstract Gastrointestinal symptoms are common in both inflammatory and non-inflammatory connective tissue disorders and can involve any part of the gastrointestinal tract from the mouth to the anus. Dysphagia, gastrooesophageal reflux, nausea, vomiting, abdominal pain and change in bowel habit are common symptoms and usually arise from gastrointestinal dysmotility and altered visceral sensitivity. In scleroderma, sensorimotor dysfunction is pronounced and can result in complications such as Barrett's oesophagus, gastroparesis, small intestinal bacterial overgrowth, malabsorption and malnutrition, with an associated reduction in survival. Treatment is aimed at symptom control and prevention of complications. In hypermobile Ehlers–Danlos syndrome, symptoms are often caused by functional gastrointestinal disorders such as functional dyspepsia or irritable bowel syndrome, or are secondary to associated co-morbidities (e.g. chronic pain, anxiety, postural tachycardia syndrome, opioid use). Dysmotility in the oesophagus, stomach and colon is common, so gastrointestinal physiology testing can be informative and prokinetics can be useful therapeutically. A holistic approach to management must be taken to address all contributing factors, especially anxiety and diet.