Gastric Antral Vascular Ectasia in Systemic Sclerosis: Current Concepts

Area of Science:

• Gastroenterology
• Rheumatology
• Internal Medicine

Background:

• Gastric antral vascular ectasia (GAVE), known as "watermelon stomach," is a rare gastrointestinal finding.
• GAVE is occasionally associated with systemic sclerosis, but its underlying pathophysiology remains unclear.

Purpose of the Study:

• To review the current literature on Gastric Antral Vascular Ectasia (GAVE) in patients with Systemic Sclerosis.
• To understand the presentation, pathogenesis, and management of GAVE within the context of systemic sclerosis.

Main Methods:

• A comprehensive literature search was conducted across major databases: Medline, Scopus, Embase, PubMed, and Cochrane.
• Keywords included "Gastric antral vascular ectasia," "Watermelon Stomach," "GAVE," "Scleroderma," and "Systemic Sclerosis."
• Fifty-four relevant papers were selected for this review.

Main Results:

• GAVE is a rare manifestation within the spectrum of systemic sclerosis, with largely unknown pathogenesis.
• Patients with systemic sclerosis and GAVE often present with anemia, iron deficiency, or significant gastrointestinal bleeding.
• First-line treatments include symptomatic therapy and endoscopic ablation; surgery is reserved for refractory cases.

Conclusions:

• Gastric antral vascular ectasia (GAVE) is diagnosable and treatable, with early detection being paramount for effective management.
• A high index of suspicion is essential for timely diagnosis and intervention in patients with systemic sclerosis.
• Further research is needed to elucidate the precise role and mechanisms of GAVE in systemic sclerosis.