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Continuing Medical Education Questions: December 2019.

Ganesh R Veerappan1

  • 1Akron Digestive Disease Consultants, Akron, Ohio.

The American Journal of Gastroenterology
|December 5, 2019
PubMed
Summary

Systemic sclerosis gastrointestinal issues, particularly colonic problems, are often overlooked. This review highlights the under-reporting of colonic manifestations and complications in systemic sclerosis patients.

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Area of Science:

  • Gastroenterology
  • Rheumatology
  • Internal Medicine

Background:

  • Systemic sclerosis is a multisystem autoimmune disease characterized by fibrosis, vascular abnormalities, and immune dysregulation.
  • Gastrointestinal (GI) involvement is common in systemic sclerosis, affecting up to 90% of patients.
  • Colonic manifestations are frequently reported but may be under-recognized compared to upper GI tract issues.

Purpose of the Study:

  • To systematically review and synthesize the existing literature on colonic manifestations and complications in systemic sclerosis.
  • To assess the prevalence and spectrum of colonic involvement in systemic sclerosis.
  • To emphasize the under-reporting of these specific complications.

Main Methods:

  • A comprehensive systematic literature search was conducted across major medical databases (e.g., PubMed, Embase, Scopus).

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  • Studies reporting on colonic manifestations or complications in patients diagnosed with systemic sclerosis were included.
  • Data extraction focused on types of colonic involvement, diagnostic methods, and reported outcomes.

    • Main Results:

    • The review identified a wide range of colonic manifestations, including pseudo-obstruction, dysmotility, diverticulosis, and ischemic colitis.
    • Complications such as perforation, bleeding, and malnutrition were associated with these manifestations.
    • Evidence suggests a significant under-reporting of these colonic issues in the literature, potentially leading to delayed diagnosis and management.

    Conclusions:

    • Colonic manifestations and complications are a significant, yet under-reported, aspect of systemic sclerosis.
    • Increased awareness and systematic evaluation of the colon are crucial for comprehensive patient care.
    • Further research is needed to elucidate the pathophysiology and optimize treatment strategies for colonic involvement in systemic sclerosis.