Dysmotility Syndrome in Systemic Scleroderma

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Correlation with other Complications


Abstract PaintingDysmotility 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. PubMed, 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.


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. ISRN Gastroenterology.


Intestinal Motility Disorders Differential Diagnoses. Failure to make the correct diagnosis of an intestinal motility disorder is a medicolegal pitfall, especially in patients with irritable bowel syndrome (IBS), because several cancers of the digestive tract mimic this condition, even in late stages. Medscape.

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.

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.

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 disorders and gastrointestinal and liver dysfunction: A state of the art review. In this review, we discuss disorders of the thyroid-gut axis and identify the evidence base behind the management of such disorders. PubMed, Eur J Intern Med, 2015 Oct;26(8):563-71. (Also see Thyroid Disease and Liver Involvement)

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…


The 5-HT1A receptor agonist buspirone improves esophageal motor function and symptoms in systemic sclerosis: a 4-week, open-label trial. More conclusive evaluation is needed; however, buspirone could potentially be given under observation for objective improvement in all patients with SSc who report reflux symptoms despite undergoing standard treatment. BioMed Central, Arthritis Research & Therapy, 09/01/2016. (Also see Scleroderma Clinical Trials)

Possible implications of TGF-alpha in eosophageal dysmotility in systemic sclerosis (SSc). These results point to a possible relation between TGF-a and oesophageal dysmotility in SSc, which is intriguing and requires further investigation. PubMed, Clin Exp Rheumatol, 2014 Aug 1.

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