title: Joint hypermobility: a common association with complex functional gastrointestinal disorders.
abstract: OBJECTIVE
  To evaluate the prevalence of joint hypermobility (JH) and comorbid conditions in children and young adults referred to a tertiary care neurogastroenterology and autonomic disorders clinic for functional gastrointestinal complaints.
  
  
  METHODS
  This was a retrospective chart review of 66 new patients aged 5-24 years who fulfilled at least 1 pediatric Rome III criteria for a functional gastrointestinal disorder (FGID) and had a recorded Beighton score (n = 45) or fibromyalgia tender point score (n = 45) based on physician examination. Comorbid symptoms were collected and autonomic testing was performed for evaluation of postural tachycardia syndrome (POTS).
  
  
  RESULTS
  The median patient age was 15 years (range, 5-24 years), 48 (73%) were females, and 56% had JH, a significantly higher rate compared with population studies of healthy adolescents (P < .001; OR, 10.03; 95% CI, 5.26-19.13). POTS was diagnosed in 34% of patients and did not correlate significantly with hypermobility. Comorbid conditions were common, including sleep disturbances (77%), chronic fatigue (93%), dizziness (94%), migraines (94%), chronic nausea (93%), and fibromyalgia (24%).
  
  
  CONCLUSIONS
  JH and other comorbid symptoms, including fibromyalgia, occur commonly in children and young adults with complex FGIDs. POTS is prevalent in FGIDs but is not associated with hypermobility. We recommend screening patients with complex FGIDs for JH, fibromyalgia, and comorbid symptoms such as sleep disturbances, migraines, and autonomic dysfunction.
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Center for Pediatric Neurogastroenterology, Motility, and Autonomic Disorders, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Katja
authors.initials: K
authors.lastname: Kovacic
authors.affiliation: Department of Neurology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Chelimsky
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Center for Pediatric Neurogastroenterology, Motility, and Autonomic Disorders, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Manu R
authors.initials: MR
authors.lastname: Sood
authors.affiliation: Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Pippa
authors.initials: P
authors.lastname: Simpson
authors.affiliation: Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Melodee
authors.initials: M
authors.lastname: Nugent
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Center for Pediatric Neurogastroenterology, Motility, and Autonomic Disorders, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Gisela
authors.initials: G
authors.lastname: Chelimsky
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications*; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D014922:Wisconsin / Q000453:epidemiology; D055815:Young Adult