Upper gastrointestinal tract: Manifestations of systemic sclerosis

John O. Clarke*, John Erik Pandolfino

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

The gastrointestinal tract is the most common organ system affected by systemic sclerosis (SSc) other than the skin. Greater than 90 % of SSc patients have esophageal involvement, and this primarily manifests as reflux and dysphagia. In addition to symptoms, complications include stricture, candidal esophagitis, and Barrett’s esophagus. There is an association between esophageal dysmotility and pulmonary disease, although causality has not been established. Gastric involvement is less common and can manifest as dysmotility or bleeding. Dysmotility often presents with impaired gastric emptying and associated symptoms, including nausea, postprandial fullness, bloating, and weight loss. Bleeding is often due to gastric antral vascular ectasia. While this affects a minority of SSc patients, consequences can be significant. This chapter will review the data regarding foregut manifestations and specifically will focus on diagnostic modalities and treatment options-including lifestyle modification, medical therapy, alternative therapy, endoscopic options, and surgical approaches where appropriate. Unfortunately, treatment remains supportive at present, and there is a lack of disease-modifying therapeutic options.

Original languageEnglish (US)
Title of host publicationScleroderma
Subtitle of host publicationFrom Pathogenesis to Comprehensive Management
PublisherSpringer International Publishing
Pages427-441
Number of pages15
ISBN (Electronic)9783319314075
ISBN (Print)9783319314051
DOIs
StatePublished - Jan 1 2016

Keywords

  • Dysphagia
  • Esophageal dysmotility
  • Esophageal manometry
  • Gastric antral vascular ectasia
  • Gastroesophageal reflux
  • Gastroparesis
  • Prokinetics
  • Proton pump inhibitors
  • Scleroderma

ASJC Scopus subject areas

  • Medicine(all)

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