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Peer-reviewedCC BYCureus

Refractory Gastroparesis in Ehlers-Danlos Syndrome: Failure of Pyloric-Directed Therapy Despite Normal Pyloric Physiology.

  • Katherine Stevens1
  • Michael Herman2
  1. 1Osteopathic Medicine, Lincoln Memorial University, Knoxville, USA.
  2. 2Gastroenterology, Borland Groover, Jacksonville, USA.
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Abstract

Gastroparesis is increasingly recognized in patients with Ehlers-Danlos syndrome (EDS), often driven by underlying autonomic dysfunction rather than pyloric pathology. We present a case of severe, refractory gastroparesis in a patient with EDS requiring post-pyloric enteral feeding and demonstrating no response to pyloric-directed therapy despite normal pyloric physiology on EndoFLIP. The patient ultimately improved following placement of a gastric electrical stimulator and optimization of enteral feeding strategies. This case highlights the importance of physiologic assessment in gastroparesis and demonstrates an association between normal pyloric physiology and limited response to pyloric-directed therapy in the setting of underlying neuropathic dysmotility.

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Cite

BibTeXRIS
BibTeX
@article{stevens2026refractory,
  title = {{Refractory Gastroparesis in Ehlers-Danlos Syndrome: Failure of Pyloric-Directed Therapy Despite Normal Pyloric Physiology.}},
  author = {Katherine Stevens and Michael Herman},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116640},
  url = {https://europepmc.org/article/MED/42910199},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Refractory Gastroparesis in Ehlers-Danlos Syndrome: Failure of Pyloric-Directed Therapy Despite Normal Pyloric Physiology.
AU  - Katherine Stevens
AU  - Michael Herman
PY  - 2026
DA  - 2026/09/21
JO  - Cureus
DO  - 10.7759/cureus.116640
UR  - https://europepmc.org/article/MED/42910199
AB  - Gastroparesis is increasingly recognized in patients with Ehlers-Danlos syndrome (EDS), often driven by underlying autonomic dysfunction rather than pyloric pathology. We present a case of severe, refractory gastroparesis in a patient with EDS requiring post-pyloric enteral feeding and demonstrating no response to pyloric-directed therapy despite normal pyloric physiology on EndoFLIP. The patient ultimately improved following placement of a gastric electrical stimulator and optimization of enteral feeding strategies. This case highlights the importance of physiologic assessment in gastroparesis and demonstrates an association between normal pyloric physiology and limited response to pyloric-directed therapy in the setting of underlying neuropathic dysmotility.
SN  - 2168-8184
ER  -