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Gastrointestinal manifestations of scleroderma
S Rose1, M A Young, J C Reynolds
1Mount Sinai School of Medicine, New York, New York, USA. suzanne_rose@smtplink.mssm.edu
Gastroenterology Clinics of North America
|January 19, 1999
Summary
Scleroderma frequently affects the gastrointestinal tract, causing motility issues like GERD and constipation. Early symptom evaluation in scleroderma patients can improve quality of life.
Area of Science:
- Gastroenterology
- Rheumatology
- Immunology
Background:
- Gastrointestinal (GI) involvement is a common manifestation of scleroderma, a systemic autoimmune disease.
- GI symptoms can precede the formal diagnosis of scleroderma by months to years.
- The esophagus is most frequently affected, but the stomach, small bowel, colon, and anorectum can also exhibit functional problems.
Purpose of the Study:
- To summarize the common gastrointestinal manifestations in scleroderma.
- To discuss the underlying pathophysiologic mechanisms.
- To highlight the clinical implications of GI symptoms in scleroderma management.
Main Methods:
- Review of existing literature on gastrointestinal involvement in scleroderma.
- Analysis of pathophysiologic mechanisms including smooth muscle atrophy and fibrosis.
- Correlation of GI symptoms with disease progression and patient outcomes.
Main Results:
- Scleroderma-associated GI dysfunction stems from smooth muscle atrophy and fibrosis, leading to motility disturbances.
- Common GI issues include gastroesophageal reflux disease (GERD), pseudo-obstruction, bacterial overgrowth, and defecatory disorders.
- Malnutrition is a significant potential complication.
Conclusions:
- Gastrointestinal symptoms are integral to the scleroderma disease process.
- Prompt evaluation and management of GI symptoms are crucial for improving patient well-being and quality of life.
- Understanding GI involvement aids in comprehensive scleroderma care.