A Rare Co-Occurrence of Gastric Heterotopia and Autonomic Nervous System Dysfunction: An Attempt to Explain If There Is a Need to Explore Possible Syndromic Link.

Gastric heterotopia (GHT) is the presence of gastric mucosa outside the stomach, including in the rectum. A 59-year-old man presented with rectal bleeding and altered bowel habits, along with long-standing low blood pressure and erectile dysfunction. Investigations confirmed rectal GHT, initially managed conservatively, followed by mucosectomy, which improved his gastrointestinal symptoms. However, persistent dizziness, blurred vision, and urinary symptoms prompted neurological evaluation, revealing autonomic nervous system (ANS) dysfunction. This case represents the first reported co-occurrence of GHT and ANS dysfunction. Although both conditions are rare and typically unrelated, their co-presentation suggests a possible link. We hypothesize that chronic inflammation or neurochemical signaling from ectopic gastric mucosa may contribute to autonomic disruption. Further research is needed to explore shared pathophysiological mechanisms.