Demographics and clinical features associated with abnormal small bowel motility in systemic sclerosis

The small bowel is affected in up to 50% of systemic sclerosis (SSc) patients, and some patients experience severe complications. Our aim was to use specific statistical methods to compare demographic and clinical features of SSc patients with and without abnormal small bowel to better characterize patients at risk for this complication.

SSc patients with gastrointestinal symptoms were prospectively enrolled and underwent a scintigraphy-based whole gut transit (WGT) study. A cross-sectional analysis was performed comparing clinical features between patients with and without abnormal small bowel transit by WGT. Univariate logistic regression models and multivariable models were used to examine the relationship between clinical features and abnormal small bowel transit.

Of 130 patients enrolled in this study, 22 had abnormal small bowel transit. SSc patients with abnormal small bowel transit were more likely to be male [odds ratio (OR) = 3.70; 95% CI: 1.07, 12.50; P = 0.038] and have more severe cardiac involvement (OR = 3.98; 95% CI: 1.10, 14.38; P = 0.035), while they were less likely to have sicca symptoms (OR = 0.30; 95% CI: 0.10, 0.94; P = 0.039). In multivariable analyses, sicca symptoms (OR = 0.28; 95% CI: 0.08, 0.96; P = 0.043) remained negatively associated with abnormal small bowel transit. Additionally, SSc patients with abnormal small bowel transit had higher mortality than patients with normal small bowel transit [hazard ratio (HR) = 4.57; 95% CI: 1.58, 13.24; P = 0.005].

These findings suggest that patients with abnormal small bowel transit in SSc are more likely to be male, have more severe cardiac involvement, higher mortality and fewer sicca symptoms. Recognizing this patient subgroup is essential for risk stratification and optimizing clinical care.