When many people hear the word hypermobility, they think of flexible joints: elbows that bend a little too far, knees that “lock out,” or the ability to put your palms flat on the floor without bending your knees. But for some people, hypermobility is about much more than flexibility.
Hypermobility exists on a spectrum. Some people have joint hypermobility without significant symptoms, while others experience a broader pattern of symptoms associated with hypermobility spectrum disorders (HSD) or hypermobile Ehlers-Danlos syndrome (hEDS).
These conditions can affect multiple body systems, including the musculoskeletal, nervous, cardiovascular, and gastrointestinal systems.
And two areas that deserve more attention are digestion and proprioception.
First: What is hypermobility?
Joint hypermobility means that a joint can move through a greater range of motion than is typical. When hypermobility is associated with symptoms such as joint instability, pain, recurrent injuries, or other systemic features, a person may meet criteria for HSD or, in some cases, hEDS.1
Importantly, being flexible does not automatically mean that someone has a connective tissue disorder. Hypermobility exists on a spectrum, and diagnosis requires a clinical evaluation.
In both hEDS and HSD, the connective tissues that provide structure and support throughout the body may function differently. This can influence how joints, muscles, fascia, and other tissues respond to mechanical stress.
Connection between hypermobility and gastrointestinal (GI) function
In order to digest food, the gastrointestinal tract has to coordinate:
- swallowing and movement of food through the esophagus
- stomach stretching and emptying
- intestinal contractions or peristalsis
- movement of stool through the colon
- absorption of nutrients
- communication between the gut, brain, and autonomic nervous system
The GI tract also contains an extensive network of nerves and communicates continuously with the brain through the gut-brain axis.
For people with hEDS or HSD, gastrointestinal symptoms are common. Research has found higher rates of symptoms including abdominal pain, reflux, nausea, bloating, constipation, diarrhea, and early or prolonged fullness.1,2 Disorders of gut-brain interaction, including functional dyspepsia and irritable bowel syndrome, are also frequently reported. For example, a 2026 systematic review and meta-analysis found that over 60% of people with hEDS/HSD reported at least one chronic GI symptom.2
How might hypermobility affect the GI tract?
Current research suggests that GI symptoms in hEDS/HSD are multifactorial. Possible contributors include connective-tissue differences, GI motility changes, autonomic dysfunction, disorders of gut-brain interaction, structural differences, and other co-occurring conditions.
- Connective tissue provides structure throughout the GI system
Connective tissue is found throughout the body, including the tissues that support and surround internal organs. In some connective tissue disorders, structural changes can contribute to problems such as hiatal hernia, rectal prolapse, or other changes in the support of abdominal and pelvic structures. Functional problems with GI motility have also been reported.1
- Gut motility may be affected
The digestive tract relies on coordinated muscular contractions and neural signaling to move food and waste through the body.
Some people with hEDS/HSD experience GI dysmotility,2 meaning that movement through part of the digestive tract may be altered.
Symptoms can include:
- reflux
- nausea
- vomiting
- early satiety
- prolonged fullness
- bloating
- abdominal pain
- constipation
- diarrhea
- The autonomic nervous system may be part of the picture
Digestion is heavily regulated by the autonomic nervous system: the part of the nervous system involved in functions we don’t consciously control, including heart rate, blood pressure, and digestion.
Autonomic dysfunction and orthostatic intolerance, including POTS, are common in people with HSD/hEDS.2 GI symptoms can occur alongside these conditions, and research increasingly recognizes the overlap between autonomic dysfunction and GI symptoms.
This doesn’t mean that POTS causes every GI symptom or that everyone with hypermobility has dysautonomia. Rather, it highlights why looking at digestion in isolation may miss part of the picture.
And then there is proprioception..
Proprioception is your sense of where your body is in space and how it is moving.
You don’t have to look at your knee to know that your leg is bent. You don’t have to watch your foot while walking to know where it is.
Your nervous system is continuously receiving information from muscles, tendons, joints, skin, and other tissues to help your brain understand: Where am I? How am I moving? How much force am I using?
For people with hypermobility, proprioception may be altered.3 The Ehlers-Danlos Society also recognizes reduced proprioception as a feature that may occur with HSD.1
Why might hypermobility affect proprioception?
When the brain tries to control a joint, it needs information about where the joint is, how quickly it is moving, and how much force is being applied.
If a joint has a greater range of motion or is less mechanically stable, the nervous system may have to work harder to create stability and accurately interpret movement.
This doesn’t mean that someone with hypermobility is inherently “uncoordinated.”
Instead, their nervous system may be receiving and integrating sensory information differently and muscles may need to provide additional active support around a joint.
Proprioception is not the same thing as interoception
This distinction is especially important when we start talking about eating and GI symptoms.
Proprioception = information about the position and movement of the body.
Interoception = information about the internal state of the body.
Interoceptive signals include things like:
- hunger
- fullness
- thirst
- heart rate
- temperature
- nausea
- bladder fullness
- the sensation of needing to have a bowel movement
These systems overlap and communicate with the brain, but they are not interchangeable.
A person may experience significant fullness, bloating, nausea, or abdominal discomfort without there being a simple one-to-one relationship between the sensation and what is physically happening in the GI tract.
And the reverse can also be true: physiological changes may occur without strong conscious awareness.
What does this mean for eating and nutrition?
Someone with hypermobility and GI symptoms2 may be navigating several things simultaneously:
- altered motility
- reflux or nausea
- constipation or diarrhea
- abdominal pain or bloating
- orthostatic symptoms
- fatigue
- pain
- altered proprioception
- changes in hunger or fullness cues
- fear of symptoms after eating
- a growing list of “safe” or “unsafe” foods
But more restriction is not automatically better GI care.
A nutrition approach should consider symptom management while also protecting adequate energy, protein, carbohydrate, fat, fiber, fluids, micronutrients, and overall nutritional status.
For some people, that may mean modifying meal size, timing, texture, fiber type or amount, hydration, or other factors based on their specific symptoms and medical evaluation.
For others, the priority may be maintaining nutritional adequacy while working with a gastroenterologist and other members of the care team to identify the underlying contributors to symptoms. There is no single “hypermobility diet.”
A whole-person approach matters
One of the most important lessons from the emerging research is that hEDS or HSD cannot be understood by looking at one body part at a time.
The joints, muscles, connective tissues, autonomic nervous system, GI tract, and brain are constantly communicating.
That doesn’t mean every symptom has one underlying cause.
The body is interconnected.
For someone experiencing hypermobility alongside GI symptoms, appropriate care may involve a multidisciplinary team that could include a physician, gastroenterologist, dietitian, physical therapist, occupational therapist, and other specialists depending on the individual’s symptoms.
And from a nutrition perspective, the goal is to ask:
What is happening physiologically?
What is happening behaviorally?
What is happening in the nervous system?
And how can we support adequate nourishment while respecting the person’s actual symptoms and lived experience?
Nutrition Support for Hypermobility and GI Symptoms
Living with hypermobility and GI symptoms can make eating feel complicated. When food becomes associated with bloating, pain, reflux, nausea, constipation, or other uncomfortable symptoms, it can be tempting to keep eliminating foods in search of an answer.
But a smaller list of foods isn’t necessarily a healthier gut or a healthier relationship with food.
At Laura Cipullo Whole Nutrition + Yoga, we take a whole-person, inclusive approach to nutrition. Our dietitians take a neuroendocrine approach, considering GI symptoms alongside medical history, metabolic health, nutritional needs, nervous system, eating patterns, and relationship with food.
Your symptoms are real. Your body is giving you information. And you don’t have to choose between taking your GI symptoms seriously and protecting your relationship with food.
Learn more about nutrition counseling at Laura Cipullo Whole Nutrition + Yoga.
References
- The Ehlers-Danlos Society. Hypermobile Ehlers-Danlos syndrome (hEDS). Accessed September 22, 2026. https://www.ehlers-danlos.com/heds/
- Kulin D, Holtmann G, Fairlie T, et al. Meta-Analysis: Chronic Gastrointestinal Symptoms and Comorbidities in Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders. Aliment Pharmacol Ther. 2026;64(5):574-589. doi:10.1111/apt.70856
