Gastrointestinal Involvement in Systemic Sclerosis: Overview, Neglected Aspects, Malnutrition, Body Composition and Management

Abstract

Gastrointestinal tract (GIT) involvement is the most common internal organ manifestation and is present in up to 90% of patients with systemic sclerosis (SSc). Clinical manifestations can differ according to the part of the GIT affected, disease course and symptoms. A majority of the symptoms are caused by GIT dysmotility. Up to 8% of SSc patients develop several GIT symptoms, which increase the mortality. Although GIT involvement is rarely the direct cause of death, it can lead to several comorbidities including malnutrition and negative alterations of body composition. These factors have a negative impact on quality of life and increase the mortality. To date, the treatment is rather symptomatic. The pathogenesis of GIT involvement in SSc still remains to be clarified to improve the treatment approaches including intravenous immunoglobulins and microRNA interventions.

Gastrointestinal involvement in systemic sclerosis: An updated review

“…The gastrointestinal complications in SSc potentially impact the quality of life and elevate the risk of mortality. [ 94 ] Their therapeutic management proves highly challenging in a variety of clinical scenarios. [ 94 , 95 ] The GI complications of scleroderma potentially trigger serious clinical complications that deteriorate the structure and function of the intestine, gastric region, esophagus, oropharynx, and visceral organs.…”

“…[ 94 ] Their therapeutic management proves highly challenging in a variety of clinical scenarios. [ 94 , 95 ] The GI complications of scleroderma potentially trigger serious clinical complications that deteriorate the structure and function of the intestine, gastric region, esophagus, oropharynx, and visceral organs. The high prevalence of esophageal and bowel manifestations in SSc substantially deteriorates the affected patients’ quality-assisted life years and survival rate.…”

“…[ 85 , 96 ] Approximately 1 to 5th of SSc patients experience Secondary Sjogren Syndrome, leading to loss of teeth due to dental caries and periodontal diseases. [ 94 , 97 ]…”

“…[85,96] Approximately 1 to 5th of SSc patients experience Secondary Sjogren Syndrome, leading to loss of teeth due to dental caries and periodontal diseases. [94,97] Approximately 50% to 90% of patients with scleroderma experience esophageal manifestations. [41,85] The early identification of esophageal complications in scleroderma cases is necessary to reduce the risk of fatal manifestations.…”