Overview

Eosinophilic Gastrointestinal Diseases (EGIDs), Connective Tissue Disorders (CTDs), and POTS often overlap in complex ways that impact diagnosis and management. Many people with EGIDs experience symptoms beyond the gut, including fatigue, dizziness, joint pain, and autonomic dysfunction, which can signal underlying CTDs or Postural Orthostatic Tachycardia Syndrome (POTS).

Understanding these connections is crucial for timely recognition, personalised care, and improving quality of life. This page explores the links between EGIDs, CTDs, and POTS, highlighting why a broader clinical perspective is essential for patients and healthcare providers.

What are Connective Tissue Disorders (CTDs)?

Connective Tissue Disorders (CTDs) are a group of conditions that affect the body’s connective tissues, including skin, joints, blood vessels, and organs. Common examples include Ehlers-Danlos Syndrome (EDS), Marfan Syndrome, and autoimmune disorders such as lupus and rheumatoid arthritis.

Symptoms can range from joint hypermobility and chronic pain to cardiovascular and gastrointestinal complications. CTDs are increasingly observed in people with EGIDs, with data showing between 10 and 20% comorbidity. Recognising these overlaps can help healthcare providers identify underlying causes of multi-system symptoms and guide more personalised holistic care.

What Is Postural Orthostatic Tachycardia Syndrome (POTS)

Postural Orthostatic Tachycardia Syndrome (POTS) is a form of dysautonomia, a disorder of the autonomic nervous system, where the heart rate rises excessively upon standing. Common symptoms include lightheadedness, rapid heartbeat, fatigue, brain fog, and sometimes fainting.

POTS can significantly affect daily life and is increasingly recognised in patients with EGIDs or connective tissue disorders, highlighting the importance of considering autonomic dysfunction when evaluating complex, multi-system symptoms.


EGIDs, Connective Tissue Disorders (CTDs), and POTS

Presented by:

  • Joshua B. Wechsler, MD, MSCI, Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine. Paediatrics (Gastroenterology, Hepatology, and Nutrition), Medicine (Allergy and Immunology


hands with paper intestines representing eosinophilic gastrointestinal diseases

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Learn about the links between Eosinophilic Gastrointestinal Diseases (EGIDs), connective tissue disorders (CTDs), and Postural Orthostatic Tachycardia Syndrome (POTS/dysautonomia).


Key Questions Covered in the Video:

    1. EoE Overview: inflammation progression and scarring, pathogenesis
    2. Mast cell activation in EoE
    3. Correlation of mast cells in the distal oesophagus with chest pain and nausea/vomiting
    4. Enteric nervous system (ENS) interactions with mast cells
    5. Dysautonomia and POTS: signs and symptoms
    6. Diagnosis and treatment of Dysautonomia/POTS
    7. POTS prevalence increase in adults
    8. COMPASS-31: a validated survey of autonomic dysfunction
    9. Post-COVID symptoms in children with re-analysis of COMPASS-31 study participants
    10. Connective Tissue Diseases (CTD) & Hypermobility: signs and symptoms
    11. CTD patients and increased risk of EoE
    12. Diagnosis, treatment of CTD & Risk of EoE
    13. Increased GI symptoms in hypermobile patients
    14. Increased GI symptoms, hypermobility, and anxiety/depression in paediatric dysautonomia
    15. Hypermobile syndromes common in patients with MCAS; hEDS, POTS and MCAS triad
    16. EoE in patients with dysautonomia and hypermobility - Study findings
    17. Correlation of EoE symptom frequency/severity with COMPASS-31
    18. Correlation of COMPASS-31 with PedQL 4.0 (quality of life scores)
    19. Intersection of dysautonomia & hypermobility
    20. Is there an intersection of dysautonomia or CTD with mast cells?
    21. Summary

    Further Resources

    What is Eosinophil?

    High Prevalence of GI Disorders in Joint Hypermobility Patients. Study Findings

    Eosinophilic Diseases Research: Past, Present and Future

    Biologics for Eosinophilic Diseases: Latest News & Research


    This resource was developed with support from the National Lottery Community Fund.