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Related Experiment Videos

Gastrointestinal features of scleroderma

R W Sjogren1

  • 1Gastroenterology Section, Kaiser Permanente Medical Center, Fall Church, VA 22046, USA.

Current Opinion in Rheumatology
|November 1, 1996
PubMed
Summary
This summary is machine-generated.

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Systemic sclerosis frequently causes gastrointestinal issues, often due to vasculopathy. Treatments like proton pump inhibitors and prokinetic agents can manage symptoms and prevent complications.

Area of Science:

  • Gastroenterology
  • Rheumatology
  • Internal Medicine

Background:

  • Systemic sclerosis commonly affects the gastrointestinal tract, with early pathology marked by vasculopathy leading to ischemia and dysfunction.
  • Gastrointestinal symptoms are often subclinical in a third of patients, necessitating thorough investigation.
  • Esophageal dysfunction, gastroparesis, and small intestinal bacterial overgrowth are key manifestations.

Purpose of the Study:

  • To review the pathophysiology and management of gastrointestinal involvement in systemic sclerosis.
  • To highlight effective therapeutic strategies for common gastrointestinal complications.
  • To discuss diagnostic approaches and surgical options for intestinal failure.

Main Methods:

  • Literature review of studies on gastrointestinal manifestations in systemic sclerosis.

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  • Analysis of treatment efficacy for reflux, gastroparesis, and malabsorption.
  • Evaluation of diagnostic tools and surgical interventions.

    • Main Results:

    • High-dose proton pump inhibitors are safe and effective for reflux, preventing esophagitis and strictures.
    • Prokinetic agents like metoclopramide, domperidone, octreotide, and erythromycin show efficacy in pseudoobstruction.
    • Combination therapies (octreotide/erythromycin) may be particularly effective, while cisapride/erythromycin is contraindicated due to cardiac risks.

    Conclusions:

    • Gastrointestinal involvement in systemic sclerosis requires tailored management strategies.
    • Early diagnosis and appropriate treatment of complications like reflux and gastroparesis are crucial.
    • Surgical intervention may be necessary for intestinal failure, requiring careful preoperative assessment.