Scleroderma Gastrointestinal Involvement |
| Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer |
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What is GI Involvement in Systemic Sclerosis (Scleroderma)? |
| GI involvement consists of a variety of symptoms and conditions that include nausea and vomiting, difficulty with swallowing, constipation, diarrhea, GERD (gastroesophageal reflux disease), problems with digestion, gastroparesis, and watermelon stomach. |
| Some of these symptoms are bothersome and can have a serious affect on your quality of life. Others are life threatening. All should be taken seriously and discussed with your doctor. (Also see: Scleroderma Gastrointestinal Involvement, What is Scleroderma?, Types of Scleroderma, and Systemic Sclerosis |
| Profile of gastrointestinal involvement in patients with systemic sclerosis The results of the study show that in reality, a much higher (nearly all) percentage of (98.9%) patients than expected suffer from GI-symptoms, regardless of the stage of their disease. T. Schmeiser, Rheumatology International DOI: 10.1007/s00296-011-1988-6. |
| Profile of gastrointestinal involvement in patients with systemic sclerosis. The results of the study show that in reality, a much higher (nearly all) percentage of (98,9%) patients than expected suffer from GI-symptoms, regardless of the stage of their disease. T. Schmeiser, (SpringerLink) Rheumatology International. July 2011. |
| The gastric wall in systemic sclerosis patients: a morphological study. This study provides evidence for a prominent fibrosis and severe ultrastructural alterations of smooth muscle cells and nerve fibres as the main histopathological hallmarks in the gastric wall of systemic sclerosis patients. Manetti M (PubMed) Ital J Anat Embryol. 2010;115(1-2):115-21. |
| Gastrointestinal manifestations of systemic sclerosis (scleroderma). Nearly 90 percent of patients with systemic sclerosis (scleroderma) have some degree of gastrointestinal (GI) involvement, with approximately one-half being symptomatic. Severe GI problems, including malabsorption and intestinal pseudoobstruction, are much less common, affecting less than 10 percent of patients during the first nine years of illness. Stephanie A Kaye-Barrett, MD. UpToDate for Patients. April, 2010. |
Biomarkers for GI Involvement in Systemic Scleroderma |
| Fecal calprotectin: A biomarker of gastrointestinal disease in systemic sclerosis. Fecal calprotectin is increased in a majority of patients with systemic sclerosis (SSc). It correlates with objective and clinically important features of GI disease, and fecal concentrations do not vary with plasma concentrations. K Andréasson, Intern Med 2011; 270: 50-57 (Also see: Systemic Sclerosis Prognosis and Mortality: Biomarkers) |
Correlation with Other Symptoms |
| Association of gastrointestinal involvement and depressive symptoms in patients with systemic sclerosis (SSc). SSc-associated gastrointestinal tract involvement (SSc-GIT) is an important predictor of depressive symptoms. Reflux and constipation scales of UCLA-SCTC GIT 2.0 were independently associated with CES-D (depression index). Future studies should assess if treatment of GIT symptoms will improve depressed mood in patients with SSc-GIT. Vijay Bodukam. Rheumatology, September 30, 2010. (Also see: (Also see: Depression) |
Digestive Involvement |
| Digestive involvement in systemic sclerosis is frequent and serious, because it provides morbidity and fatality. The symptomatic treatments must be systematic and improve the disease's overall prognosis. PubMed. Rev Prat. 2002 Nov 1;52(17):1896-900. |
| Malnutrition Is Common in Systemic Sclerosis: Results from the Canadian Scleroderma Research Group Database. The risk for malnutrition in SSc is moderate and is associated with shorter disease duration, markers of GI involvement, and disease severity. Patients with SSc should be screened for malnutrition, and potential underlying causes assessed and treated when possible. The Journal of Rheumatology, July 2009. (Also see: Diet and Scleroderma) |
Bowel Involvement |
| Bowel Involvement. Scleroderma can cause constipation, diarrhea, malabsorption, diminished peristalsis, intestinal pseudo-obstruction, and bowel incontinence. Typical in the initial stages of scleroderma is chronic constipation, sometimes alternating with diarrhea. Late stage scleroderma bowel involvement is often marked by diarrhea, malabsorption, and bowel incontinence. ISN. |
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Dysmotility Syndrome |
| Dysmotility syndrome refers to muscles in the gastrointestinal tract not working properly. This can include the throat (esophagus), stomach, and bowels. When the stomach is affected, it is often called gastroparesis. When it affects the bowels, it may be called intestinal pseudo-obstruction. ISN. (Also see: Esophagus, Gastroparesis, and Bowel Involvement) |
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Dysphagia (Difficulty Swallowing) |
| Dysphagia is the medical term for difficulty in swallowing. Symptoms include a sensation of food sticking in the throat, chest pressure or 'burning' after eating, or a feeling of choking. Dysphagia can be due to many different things. Occasionally it is one of the symptoms of systemic scleroderma. ISN. |
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Esophagus (Throat) |
| Esophageal (Throat) Involvement. Scleroderma can cause Barrett's Esophagus, esophageal diseases, esophageal stricture, and esophageal ulcers. ISN. |
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Esophagus: Reflux (Heartburn) |
| Esophagus: Reflux (Heartburn) and GERD. There are many effective treatments and lifestyle modifications for reflux (heartburn) which is very common in scleroderma patients. ISN. |
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Gastroparesis |
| What is Gastroparesis? Symptoms, diagnosis, treatments, and support. Gastroparesis and Dysmotilities Association. |
Gastroparesis Personal Stories |
| Jason: Linear Scleroderma I have recently been diagnosed with Raynaud's as well, have had gastrointestinal difficulties more common to systemic forms, and have witnessed these lesions grow and deepen rather than decrease in size... |
| Jody: Fibromyalgia/Difficult Diagnosis In Sudan, I was on IV for heat stroke and food poisoning. And in Thailand, at the end of March, it all came to a crashing halt... |
| Sandy J: CREST Scleroderma I have had an ileostomy for two years and a feeding peg for just over one year, and would appreciate comments from any person who also has one or both of these problems... |
| Tami: Morphea Scleroderma I have gotten used to the stares everyone casts my way because in their eyes I am different. Unique, I guess... |
| Trish: Spouse of a Diffuse Scleroderma Patient My husband was diagnosed with scleroderma in June of 2000... |
Loss of Appetite |
| A loss of appetite can occur for a great many reasons, including anxiety, depression, infection, medication and treatment side-effects, and many illnesses. There are medications that can stimulate appetite, as well as treat nausea. Loss of appetite in a scleroderma patient may be indicative of gastrointestinal involvement. If appetite loss persists, it is important to consult your medical care provider. |
Malnutrition |
| Is Serum Albumin a Marker of Malnutrition in Chronic Disease? The Scleroderma Paradigm. Serum albumin is not useful as a marker for malnutrition in SSc and should not be assumed to be useful as a marker in other chronic diseases. More attention should be paid to clinical features of malnutrition, including assessment of body mass index and unplanned weight loss, and overall disease severity. M Baron. (PubMed) J Am Coll Nutr. 2010 Apr;29(2):144-151. |
| Nutritional status as marker for disease activity and severity predicting mortality in patients with systemic sclerosis (SSc). In patients with SSc, malnutrition is common and not identified by Body Mass Index (BMI). Bioelectrical impedance analysis (BIA) parameters reflect disease severity and provide best predictors for patient survival. Therefore, an assessment of nutritional status should be performed in patients with SSc. Lijana Krause. Ann Rheum Dis. May 2010. (Also see: Diet and Scleroderma) |
| Malnutrition Is Common in Systemic Sclerosis (SSc): Results from the Canadian Scleroderma Research Group Database. The risk for malnutrition in SSc is moderate and is associated with shorter disease duration, markers of gastrointestinal (GI) involvement, and disease severity. Patients with SSc should be screened for malnutrition, and potential underlying causes assessed and treated when possible. Murray Baron. J Rheumatol. October 15, 2009. |
Pneumoperitoneum |
| Benign Spontaneous Pneumoperitoneum in Systemic Sclerosis (SSc). We report a case of spontaneous pneumoperitoneum (air or gas in the abdominal (peritoneal) cavity) without evidence of peritoneal irritation in a malnourished patient with long-standing SSc. Vischio J. (PubMed) J Clin Rheumatol. 2010 Dec;16(8):379-81. |
Watermelon Stomach |
| Watermelon Stomach is the popular name for Gastric Antral Vascular Ectasia (GAVE) — a condition in which the lining of the stomach bleeds, causing it to look like the characteristic stripes of a watermelon when viewed by endoscopy. ISN. |
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Additional Research |
| Validation of the UCLA Scleroderma Clinical Trial Gastrointestinal Tract Instrument (SCTC GITI) Version 2.0 for Systemic Sclerosis. Our study confirms that the UCLA SCTC GITI version 2.0 will be a useful tool for assessing the role of GI involvement in SSc, even in a population with substantially different characteristics than the subjects originally tested. Baron M. (PubMed) J Rheumatol. 2011 Jul 1. |
| High incidence of Helicobacter pylori infection in patients with systemic sclerosis: association with Sicca Syndrome. In patients with Systemic Sclerosis we found an enhanced frequency of HP infection. PubMed. Int J Immunopathol Pharmacol 2001 May-Aug;14(2):81-85. |
| Nausea and Vomiting Many illnesses can cause stomach pain, nausea and vomiting. Some are mild sicknesses that will pass by themselves, but others are serious and need medical attention. familydoctor.org. |
