P0532 - Prevalence of Food Intolerance and Associations with Global Health and Psychological Symptoms in Adults with Ehlers-Danlos Syndrome (EDS) or Hypermobile EDS in the United States

John Venezia, , Abid Ahmad, MD, Jhalka Kadariya, MPH, Huiping Xu, PhD, Andrea Shin, MD
Indiana University, Indianapolis, IN

Introduction: Background & Aims: High rates of food intolerance have been suggested in patients with Ehlers-Danlos Syndromes (EDS) including hypermobile type EDS (hEDS); however published research is limited. We aimed to assess diet patterns, prevalence and symptoms of food intolerance, and associations of intolerance with QoL and psychological factors in adults with and without EDS/hEDS.

Methods: We distributed an online survey to adults ≥ 18 years to collect data on demographics, dietary habits, food intolerance, symptoms of intolerance, anxiety, depression, QoL (PROMIS-10), and self-reported history of EDS or hEDS diagnostic criteria. We used Pearson’s chi-square or Fisher’s exact tests to compare rates of intolerance, dietary restrictions, and symptoms of intolerance between groups with and without EDS/hEDS and across subgroups (EDS, hEDS, non-EDS/hEDS). We used linear regression to analyze the impact of intolerance on anxiety, depression, and QoL while controlling the sociodemographic factors.

Results: Results: Of 1547 survey responses that were collected, 1193 were included in the final analysis after excluding ineligible responses (Table). Food intolerance was reported by 19.8% of all subjects. Higher rates (Table) of dietary restrictions (lactose-free, gluten-free, or low residue), food intolerance (any gastrointestinal symptom after food ingestion), and lactose intolerance were observed in EDS/hEDS (all p≤0.001). Differences in restrictions and food or lactose intolerance were also observed across subgroups (all overall p≤0.01). Higher rates of restrictions (lactose, gluten, residue) and food or lactose intolerance were observed in both EDS and hEDS compared to controls; patterns were similar between EDS and hEDS. In those with food intolerance (n=236), oral lesions were more common in EDS/Heds (Figure). EDS/hEDS subjects reported higher consistency of food reactions and smaller amounts of food required for symptoms. In adjusted analyses, intolerance was associated with higher depression and lower physical health scores in all subjects (p≤0.01). The effect of intolerance on physical (p=0.02) and mental (p=-0.01) QoL differed between groups; significant associations were observed only in controls (p< 0.001).

Discussion: Conclusions: Food or lactose intolerance and diet restrictions are prevalent in adults with EDS/hEDS. Although adults with EDS/hEDS exhibit increased psychological comorbidities and worse QoL, these factors are less affected by food than in the non-EDS/hEDS population.




Disclosures:


John Venezia, , Abid Ahmad, MD, Jhalka Kadariya, MPH, Huiping Xu, PhD, Andrea Shin, MD. P0532 - Prevalence of Food Intolerance and Associations with Global Health and Psychological Symptoms in Adults with Ehlers-Danlos Syndrome (EDS) or Hypermobile EDS in the United States, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.