Sklerodermie

Abstract

Gastrointestinal involvement in systemic sclerosis (SSc) is clinically determined by esophageal functional disorders with dysfunction of esophageal peristalsis and decrease of gastroesophageal barrier function with increased gastroesophageal reflux and its complications. Gastrointestinal involvement in SSc is relevant for the prognosis and is responsible for a significant number of deaths. The pathophysiology includes vascular alterations, fibrosis and immune alterations that most likely occur in sequential order leading to esophageal damage. Symptoms that correlate with esophageal dysfunction are dysphagia, reflux, belching, dyspepsia, pyrosis and retrosternal pain. Weight loss, nausea, vomiting, cough and hoarseness can be additional symptoms. The diagnostics include esophagogastroduodenoscopy, high-resolution esophageal manometry and combined 24 h pH impedance monitoring. Therapy comprises the treatment of the underlying disease and consistent guideline-conform treatment of reflux.