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

Year: 2026

Type: article

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.

Source: Cureus

DOI: 10.7759/cureus.116640

Authors: Katherine Stevens, Michael Herman

Institutions: Lincoln Memorial University, Borland Groover Clinic

Language: English

Topic: Gastrointestinal motility and disorders

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7213923426