Systemic Sclerosis: Gastrointestinal Disease and Its Management

Rheum Dis Clin North Am. 2015 Aug;41(3):459-73. doi: 10.1016/j.rdc.2015.04.007. Epub 2015 May 23.

Abstract

The gastrointestinal tract, affecting more than 90% of patients, is the internal organ most frequently involved in systemic sclerosis. Any part of the gastrointestinal tract can be affected, from the mouth to the anus. Patients often experience reduced quality of life and impaired social life. Although only 8% have severe gastrointestinal involvement, mortality is high in those patients. Recent studies on the pathophysiology of the disease highlight new mechanisms to explain gastrointestinal dysmotility, but treatment remains symptomatic. This article reviews the pathophysiology of the gastrointestinal tract and discusses the investigation and management of the disease.

Keywords: Constipation; Dysmotility; Esophagus; Fecal incontinence; Gastroesophageal reflux; Gastroparesis; Pseudo-obstruction; Systemic sclerosis.

Publication types

  • Review

MeSH terms

  • Anus Diseases / etiology
  • Colonic Diseases / etiology
  • Esophageal Diseases / etiology
  • Esophageal Diseases / therapy
  • Gastrointestinal Diseases / etiology
  • Gastrointestinal Diseases / therapy*
  • Humans
  • Intestinal Pseudo-Obstruction / etiology
  • Intestinal Pseudo-Obstruction / therapy
  • Intestine, Small / microbiology
  • Liver Diseases / etiology
  • Malabsorption Syndromes / etiology
  • Malnutrition / etiology
  • Mouth Diseases / etiology
  • Pneumatosis Cystoides Intestinalis / etiology
  • Rectal Diseases
  • Scleroderma, Systemic / complications*
  • Stomach Diseases / etiology
  • Stomach Diseases / therapy