Chapter 5 Gastrointestinal Involvement in Systemic Sclerosis

Abstract

Publisher Summary This chapter provides practical guidance in the diagnosis and treatment of systemic sclerosis (SSc)-associated gastrointestinal tract (GIT) involvement. Disease of the GIT occurs in approximately 90% of patients with SSc, and has a major impact on their quality of life. Every part of the GIT can be involved in SSc, including the mouth, esophagus, stomach, intestines, and anorectal system. Different GI organ systems may manifest GIT involvement in a variety of ways, the underlying pathophysiology is the same. SSc affects the distal two-thirds of the esophagus; the motility of the esophageal sphincter and proximal esophagus is generally normal. Gastric antral vascular ectasia (GAVE) is an important cause of iron deficiency anemia in patients with SSc. The majority of patients with SSc have multiple types of GIT involvement with overlapping symptoms, making quantification of GIT in SSc extremely challenging. The imaging studies and laboratory tests are used for GIT examination; physical examination of the GIT system yields little information. For motility disorders, a barium contrast study is the preferred radiographic procedure, and for assessment of mucosal disease, endoscopy is the preferred test.