Gastrointestinal involvement in systemic sclerosis: An updated review

Area of Science:

• Gastroenterology and Immunology
• Rheumatology

Background:

• Systemic scleroderma (SSc) significantly affects the gastrointestinal (GI) tract, second only to the skin.
• GI manifestations are linked to elevated morbidity and mortality rates in SSc patients.
• The incidence of SSc is approximately 19.3 per million adults in the US, with higher prevalence in females aged 44-55.

Approach:

• This article provides a comprehensive overview of GI pathology in SSc.
• It summarizes epidemiology, clinical manifestations, complications, and current treatment strategies.
• Highlights the need for multidisciplinary management and prospective studies for targeted therapies.

Key Points:

• Esophageal and intestinal involvement affects 90% and 40-70% of SSc patients, respectively.
• Small bowel hypomotility and bacterial overgrowth cause malabsorption, malnutrition, and contribute to a 50% mortality rate.
• Fecal incontinence is a common symptom, potentially leading to depression and reduced quality of life.

Conclusions:

• Gastrointestinal complications in SSc profoundly impact daily life and prognosis.
• Multidisciplinary approaches are essential for managing these complex GI issues.
• Further research into targeted therapies is needed to improve SSc patient recovery and outcomes.