Neurogastroenterology Group, Centre for Digestive Diseases, Blizzard Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK.
Neurogastroenterol Motil. 2010 Mar;22(3):252-e78. doi: 10.1111/j.1365-2982.2009.01421.x. Epub 2009 Oct 15.
BACKGROUND Unexplained gastrointestinal (GI) symptoms and joint hypermobility (JHM) are common in the general population, the latter described as benign joint hypermobility syndrome (BJHS) when associated with musculo-skeletal symptoms. Despite overlapping clinical features, the prevalence of JHM or BJHS in patients with functional gastrointestinal disorders has not been examined. METHODS The incidence of JHM was evaluated in 129 new unselected tertiary referrals (97 female, age range 16-78 years) to a neurogastroenterology clinic using a validated 5-point questionnaire. A rheumatologist further evaluated 25 patients with JHM to determine the presence of BJHS. Groups with or without JHM were compared for presentation, symptoms and outcomes of relevant functional GI tests. KEY RESULTS Sixty-three (49%) patients had evidence of generalized JHM. An unknown aetiology for GI symptoms was significantly more frequent in patients with JHM than in those without (P < 0.0001). The rheumatologist confirmed the clinical impression of JHM in 23 of 25 patients, 17 (68%) of whom were diagnosed with BJHS. Patients with co-existent BJHS and GI symptoms experienced abdominal pain (81%), bloating (57%), nausea (57%), reflux symptoms (48%), vomiting (43%), constipation (38%) and diarrhoea (14%). Twelve of 17 patients presenting with upper GI symptoms had delayed gastric emptying. One case is described in detail. CONCLUSIONS & INFERENCES In a preliminary retrospective study, we have found a high incidence of JHM in patients referred to tertiary neurogastroenterology care with unexplained GI symptoms and in a proportion of these a diagnosis of BJHS is made. Symptoms and functional tests suggest GI dysmotility in a number of these patients. The possibility that a proportion of patients with unexplained GI symptoms and JHM may share a common pathophysiological disorder of connective tissue warrants further investigation.
未明原因的胃肠道（GI）症状和关节过度活动（JHM）在普通人群中很常见，当后者伴有肌肉骨骼症状时被描述为良性关节过度活动综合征（BJHS）。尽管具有重叠的临床特征，但尚未检查功能性胃肠道疾病患者中 JHM 或 BJHS 的患病率。
使用经过验证的 5 分问卷评估了 129 名新的未经选择的三级转诊患者（97 名女性，年龄范围 16-78 岁）中的 JHM 发生率。风湿病学家进一步评估了 25 例 JHM 患者，以确定是否存在 BJHS。比较了有或没有 JHM 的组的表现、症状和相关功能性 GI 测试的结果。
63 例（49%）患者存在全身性 JHM 的证据。与没有 JHM 的患者相比，JHM 患者的 GI 症状病因不明的情况更为常见（P < 0.0001）。风湿病学家在 25 例患者中的 23 例中确认了 JHM 的临床印象，其中 17 例（68%）被诊断为 BJHS。同时存在 BJHS 和 GI 症状的患者经历了腹痛（81%）、腹胀（57%）、恶心（57%）、反流症状（48%）、呕吐（43%）、便秘（38%）和腹泻（14%）。17 例上 GI 症状患者中有 12 例存在胃排空延迟。详细描述了 1 例病例。
在一项初步的回顾性研究中，我们发现，在转诊至三级神经胃肠病学治疗的具有未明原因的 GI 症状的患者中，JHM 的发病率很高，并且在这些患者中，有一部分被诊断为 BJHS。这些患者中的一些人存在胃肠道运动功能障碍的症状和功能性测试。未明原因的 GI 症状和 JHM 的患者中，有一部分可能存在共同的结缔组织病理生理紊乱的可能性，值得进一步研究。
