Clinical Assessment of Gastrointestinal Involvement in Patients with Systemic Sclerosis Approach to gastrointestinal disease in scleroderma
Main Article Content
Abstract
Systemic sclerosis (SSc) is an autoimmune connective tissue disease that negatively impacts the function of the skin and internal organs. The gastrointestinal (GI) tract is the most commonly affected internal organ in SSc, though GI complications may also arise indirectly when infections occur in the setting of immunosuppression or concurrent disease processes arise for which patients with SSc are found to be at higher risk. In this review, we provide a systematic approach for the clinical assessment of GI complications in SSc from the oropharynx to the anorectum to guide both general internists and rheumatologists caring for this complex patient population. It is organized so that each component of the luminal GI tract has its own specified section, beginning with a review of a clinical approach to diagnosis, followed by a more detailed discussion of the literature surrounding approaches for an objective GI evaluation. A focused discussion early in the manuscript addressing what is known about pathogenesis, and later about in the manuscript about the assessment for GI bleeding are also included.
Keywords:
systemic sclerosis, scleroderma, clinical, gastrointestinal
Article Details
How to Cite
KANIECKI, Timothy; ABDI, Tsion; MCMAHAN, Zsuzsanna H..
Clinical Assessment of Gastrointestinal Involvement in Patients with Systemic Sclerosis.
Medical Research Archives, [S.l.], v. 8, n. 10, oct. 2020.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2252>. Date accessed: 23 apr. 2024.
doi: https://doi.org/10.18103/mra.v8i10.2252.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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3. Kowal-Bielecka O, Fransen J, Avouac J, et al. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2017;76(8):1327-1339.
4. Shreiner AB, Murray C, Denton C, Khanna D. Gastrointestinal manifestations of systemic sclerosis. J Scleroderma Relat Disord. 2016;1(3):247-256.
5. Gyger G, Baron M. Systemic sclerosis: Gastrointestinal disease and its management. Rheum Dis Clin North Am. 2015;41(3):459-473.
6. Kumar S, Singh J, Rattan S, DiMarino AJ, Cohen S, Jimenez SA. Review article: Pathogenesis and clinical manifestations of gastrointestinal involvement in systemic sclerosis. Aliment Pharmacol Ther. 2017;45(7):883-898.
7. Roberts CG, Hummers LK, Ravich WJ, Wigley FM, Hutchins GM. A case-control study of the pathology of oesophageal disease in systemic sclerosis (scleroderma). Gut. 2006;55(12):1697-1703.
8. Pattanaik D, Brown M, Postlethwaite BC, Postlethwaite AE. Pathogenesis of systemic sclerosis. Front Immunol. 2015;6:272.
9. Distler O, Assassi S, Cottin V, et al. Predictors of progression in systemic sclerosis patients with interstitial lung disease. Eur Respir J. 2020;55(5):1902026. doi: 10.1183/13993003.02026-2019. Print 2020 May.
10. Goldblatt F, Gordon TP, Waterman SA. Antibody-mediated gastrointestinal dysmotility in scleroderma. Gastroenterology. 2002;123(4):1144-1150.
11. Rose S, Young MA, Reynolds JC. Gastrointestinal manifestations of scleroderma. Gastroenterol Clin North Am. 1998;27(3):563-594.
12. Cohen S, Fisher R, Lipshutz W, Turner R, Myers A, Schumacher R. The pathogenesis of esophageal dysfunction in scleroderma and raynaud's disease. J Clin Invest. 1972;51(10):2663-2668.
13. Willerson JT, Thompson RH, Hookman P, Herdt J, Decker JL. Reserpine in raynaud's disease and phenomenon. short-term response to intra-arterial injection. Ann Intern Med. 1970;72(1):17-27.
14. Shah AA, Wigley FM. Often forgotten manifestations of systemic sclerosis. Rheum Dis Clin North Am. 2008;34(1):221-38; ix.
15. Malandrini A, Selvi E, Villanova M, et al. Autonomic nervous system and smooth muscle cell involvement in systemic sclerosis: Ultrastructural study of 3 cases. J Rheumatol. 2000;27(5):1203-1206.
16. Bali V, Dabra S, Behl AB, Bali R. A rare case of hidebound disease with dental implications. Dent Res J (Isfahan). 2013;10(4):556-561.
17. McFarlane IM, Bhamra MS, Kreps A, et al. Gastrointestinal manifestations of systemic sclerosis. Rheumatology (Sunnyvale). 2018;8(1):10.4172/2161-1149.1000235. Epub 2018 Mar 30.
18. Wood RE, Lee P. Analysis of the oral manifestations of systemic sclerosis (scleroderma). Oral Surg Oral Med Oral Pathol. 1988;65(2):172-178.
19. Avouac J, Sordet C, Depinay C, et al. Systemic sclerosis-associated sjogren's syndrome and relationship to the limited cutaneous subtype: Results of a prospective study of sicca syndrome in 133 consecutive patients. Arthritis Rheum. 2006;54(7):2243-2249.
20. Eversole LR, Jacobsen PL, Stone CE. Oral and gingival changes in systemic sclerosis (scleroderma). J Periodontol. 1984;55(3):175-178.
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