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Related Experiment Videos

Gastrointestinal motility disorders in scleroderma

R W Sjogren1

  • 1Kaiser Permanente Medical Center, Falls Church, VA 22046.

Arthritis and Rheumatism
|September 1, 1994
PubMed
Summary
This summary is machine-generated.

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Systemic sclerosis commonly affects the gastrointestinal tract, causing issues like reflux and pseudoobstruction. Management focuses on symptomatic relief and nutritional support, with varying success based on disease phase.

Area of Science:

  • Gastroenterology
  • Rheumatology
  • Internal Medicine

Background:

  • The gastrointestinal tract is the second most frequent site affected by systemic sclerosis after the skin.
  • Key clinical manifestations include gastroesophageal reflux, small intestinal bacterial overgrowth, malnutrition, and intestinal pseudoobstruction.

Purpose of the Study:

  • To outline the clinical manifestations of gastrointestinal involvement in systemic sclerosis.
  • To discuss current treatment strategies for these manifestations.
  • To highlight the challenges in managing malnutrition and intestinal pseudoobstruction.

Main Methods:

  • Review of clinical manifestations and treatment approaches for gastrointestinal systemic sclerosis.
  • Discussion of pharmacological interventions for gastroesophageal reflux and bacterial overgrowth.

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  • Exploration of therapeutic options for intestinal pseudoobstruction, including prokinetic drugs, dietary modifications, and nutritional support.

    • Main Results:

    • Gastroesophageal reflux is manageable with prokinetic drugs, omeprazole, and surgery; Barrett's esophagus requires endoscopic monitoring.
    • Small intestinal bacterial overgrowth typically responds to rotating antibiotics and prokinetic agents.
    • Intestinal pseudoobstruction presents challenges, with early neuropathic phases potentially responding to prokinetics and dietary changes, while late myopathic phases often require nutritional support.

    Conclusions:

    • Gastrointestinal manifestations of systemic sclerosis require tailored, symptomatic management.
    • Nutritional support and advanced interventions like home total parenteral nutrition are crucial for severe cases.
    • Surgical interventions may offer symptomatic relief in select patients with localized intestinal pseudoobstruction.