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Dysmotility Syndrome in Systemic Scleroderma

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Dysmotility Syndrome in Scleroderma
Symptoms of Dysmotility
Diagnosis of Dysmotility
Treatment and Management
Correlation with other Complications

Research on Dysmotility

Dysmotility Syndrome in Scleroderma

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. (Also see: Esophagus, Gastroparesis, Scleroderma Gastrointestinal Involvement, What is Scleroderma?, Types of Scleroderma, and Systemic Sclerosis
Dysmotility syndrome is a vague, descriptive term used to describe diseases of the muscles of the gastrointestinal tract (esophagus, stomach, small and large intestines) in which the muscles do not work normally (hence the term dysmotility). Other terms that are sometimes used for dysmotility problems are gstroparesis when the stomach is involved, and chronic intestinal pseudo-obstruction when the intestines and stomach are involved. MedicineNet.
What are Dysmotilities? Symptoms, diagnosis, treatments, and support. Gastroparesis and Dysmotilities Association.
Gastrointestinal motility disorder assessment in systemic sclerosis (Ssc). GI involvement is very frequent in SSc patients. Oesophagus and small bowel are more frequently impaired, whereas delayed gastric emptying is less common. Pub Med Rheumatology. 2013 Feb 4.
Motility Disorders. Achalasia is a neurogenic esophageal motility disorder characterized by impaired esophageal peristalsis, a lack of lower esophageal sphincter relaxation during swallowing, and an elevation of lower esophageal sphincter resting pressure. Symptomatic diffuse esophageal spasm is part of a spectrum of motility disorders characterized variously by nonpropulsive contractions, hyperdynamic contractions, or elevated lower esophageal sphincter pressure. Merck Manuals.

Symptoms of Dysmotility

Anorectal Motility and Sensation Abnormalities and Its Correlation with Anorectal Symptoms in Patients with Systemic Sclerosis (SSc): A Preliminary Study. Eight SSc patients and matched controls were queried about their GI dysmotility symptoms and quality of life (QoL) and underwent anorectal motility and sensory tests. Hanaa S. Sallam. (Hindawi) ISRN Gastroenterology Volume 2011 (2011), Article ID 402583.

Diagnosis of Dysmotility

Muscarinic-3 acetylcholine receptor autoantibody in patients with systemic sclerosis: contribution to severe gastrointestinal tract (GIT) dysmotility. The findings indicated that anti-M3R antibody very frequently appears in patients with SSc, which is accompanied by severe GIT involvement, suggesting that M3R-mediated enteric cholinergic neurotransmission may provide a pathogenic mechanism for GIT dysmotility in SSc. Kawaguchi Y, (PubMed) Ann Rheum Dis. 2009 May;68(5):710-4.
A new method for evaluation of intestinal muscle contraction properties: studies in normal subjects and in patients with systemic sclerosis. Systemic sclerosis patients had increased stiffness and impaired muscle dynamics of the duodenum. Decreased muscle function and increased wall stiffness may explain the GI symptoms reported in this patient group. PubMed. Neurogastroenterol Motil. 2007 Jan;19(1):11-9. (Also see: Bowel Dysfunction

Treatment and Management of Dysmotility

Transcutaneous Electrical Nerve Stimulation (TENS) Improves Upper GI Symptoms and Balances the Sympathovagal Activity in Scleroderma Patients. TENS at GI acupoints offers a potential option in the treatment of upper GI symptoms, but further study is necessary. PubMed. Dig Dis Sci. 2007 Mar 20.
Systematic review: pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis. Lifestyle and medical therapy approaches are preferred as they often improve and/or ameliorate symptoms. Surgery is only recommended with serious, rare complications. Alternative therapies such as acupuncture-based therapies are well tolerated, with clinical improvement and may be of potential therapeutic benefit for systemic sclerosis gastrointestinal dysmotility. PubMed. Aliment Pharmacol Ther. 2006 Mar 15;23(6):691-712.
Domperidone Warning
FDA Alert: Detention without Physical Examination of Domperidone, brands names Motilium, Euciton, Cilroton, Praxis, Seronex, Emiken. Domperidone is not approved for any use in the U.S. There have been several published reports and case studies of cardiac arrhythmias, cardiac arrest and sudden death in patients receiving an intravenous form of domperidone. U.S. Food and Drug Administration (FDA). 2004.

Correlation of Dysmotility with other Complications

Thyroid-intestinal motility interactions summary. Thyroid diseases may be related to gastrointestinal motility symptoms. Such symptoms can vary in degree and, sometimes, are the only clue of a thyroid disease or, at least, the first. PubMed. Minerva Gastroenterol Dietol. 2004 Dec;50(4):305-15. (Also see: Thyroid Disease)

Dysmotility Patient and Caregiver Stories

Amanda: Diffuse Scleroderma Systemic Sclerosis I am thirty-nine years old and was diagnosed with diffuse scleroderma systemic sclerosis in August 2007...

Research on Dysmotility

Human enteric neuropathies: morphology and molecular pathology. The aim of this study is to review current understanding of the molecular and morphological pathology of the enteric neuropathies affecting motor function of the human gastrointestinal tract. PubMed. Neurogastroenterol Motil. 2004 Oct;16(5):515-31. (Also see: Causes of Scleroderma: Molecular Defect)
 
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