Normal bowel function restored after oxygen therapy in systemic sclerosis and colonic inertia

Area of Science:

• Gastroenterology
• Rheumatology
• Pulmonology

Background:

• Progressive systemic sclerosis (pSSc) frequently leads to colorectal issues, including obstructed defecation and colonic inertia.
• These gastrointestinal complications significantly reduce patient quality of life and pose risks for severe health issues.
• Current treatments for colonic inertia in pSSc, such as laxatives and prokinetics, are often insufficient, with colectomy carrying high risks.

Observation:

• A patient with scleroderma and severe colonic inertia was scheduled for a total abdominal colectomy.
• The patient experienced respiratory decompensation and required supplemental oxygen via nasal cannula.

Findings:

• Following the initiation of nasal oxygen therapy, the patient's bowel motility spontaneously improved, leading to regular bowel movements.
• This unexpected restoration of colonic function obviated the need for the planned colectomy.

Implications:

• Non-invasive respiratory support, such as nasal oxygen, may represent a novel therapeutic approach for managing colonic inertia in select pSSc patients.
• This case highlights a potential link between respiratory function and gastrointestinal motility in systemic sclerosis, suggesting a need for further investigation.
• Conservative management with oxygen therapy could potentially reduce the morbidity and mortality associated with colectomy in this vulnerable patient population.