Gastro-intestinal involvement in systemic sclerosis
The gastrointestinal (GI) tract can be involved in up to 90% of patients with systemic sclerosis (SSc) and is the leading cause of morbidity and third most common cause of mortality in these patients. The GI involvement can occur in the absence of cutaneous manifestations in 10% of patients. Vasculo...
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SAGE Publishing
2017-01-01
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| Series: | Indian Journal of Rheumatology |
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| Online Access: | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=6;spage=156;epage=166;aulast=Kedia |
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| author | Saurabh Kedia Anuj Chhaparia Pramod Garg |
| author_facet | Saurabh Kedia Anuj Chhaparia Pramod Garg |
| author_sort | Saurabh Kedia |
| collection | DOAJ |
| description | The gastrointestinal (GI) tract can be involved in up to 90% of patients with systemic sclerosis (SSc) and is the leading cause of morbidity and third most common cause of mortality in these patients. The GI involvement can occur in the absence of cutaneous manifestations in 10% of patients. Vasculopathy, cellular and humoral immunity, and diffuse fibrosis are the principal pathogenetic mechanisms in SSc and begin with autoantibody-mediated neuronal damage followed by muscular damage and fibrosis. This leads to progressive dysmotility of the entire GI tract from mouth to anus and is responsible for the clinical manifestations including gastroesophageal reflux disease and dysphagia due to esophageal involvement, gastroparesis, small intestinal bacterial overgrowth and chronic intestinal pseudo-obstruction, and constipation due to colonic and fecal incontinence due to anorectal involvement. The clinical features resulting from the involvement of these organs often overlap and multiple areas may be involved simultaneously. The treatment remains mostly symptomatic because effective disease-modifying therapies are lacking. These patients are at a risk of malnutrition and nutritional screening, and thus rehabilitation is very important. Refractory cases require nutritional support in the form of enteral nutrition and/or home parenteral nutrition. Future research is needed in the pathogenesis, development of biomarkers for early identification of GI involvement at the asymptomatic stage, and targeted disease-modifying therapies, which can alter/halt the disease progression. |
| format | Article |
| id | doaj-art-b7e4210d87d943cdb9ddf83a89e09f95 |
| institution | Kabale University |
| issn | 0973-3698 0973-3701 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Indian Journal of Rheumatology |
| spelling | doaj-art-b7e4210d87d943cdb9ddf83a89e09f952025-02-03T12:00:10ZengSAGE PublishingIndian Journal of Rheumatology0973-36980973-37012017-01-01126156166Gastro-intestinal involvement in systemic sclerosisSaurabh KediaAnuj ChhapariaPramod GargThe gastrointestinal (GI) tract can be involved in up to 90% of patients with systemic sclerosis (SSc) and is the leading cause of morbidity and third most common cause of mortality in these patients. The GI involvement can occur in the absence of cutaneous manifestations in 10% of patients. Vasculopathy, cellular and humoral immunity, and diffuse fibrosis are the principal pathogenetic mechanisms in SSc and begin with autoantibody-mediated neuronal damage followed by muscular damage and fibrosis. This leads to progressive dysmotility of the entire GI tract from mouth to anus and is responsible for the clinical manifestations including gastroesophageal reflux disease and dysphagia due to esophageal involvement, gastroparesis, small intestinal bacterial overgrowth and chronic intestinal pseudo-obstruction, and constipation due to colonic and fecal incontinence due to anorectal involvement. The clinical features resulting from the involvement of these organs often overlap and multiple areas may be involved simultaneously. The treatment remains mostly symptomatic because effective disease-modifying therapies are lacking. These patients are at a risk of malnutrition and nutritional screening, and thus rehabilitation is very important. Refractory cases require nutritional support in the form of enteral nutrition and/or home parenteral nutrition. Future research is needed in the pathogenesis, development of biomarkers for early identification of GI involvement at the asymptomatic stage, and targeted disease-modifying therapies, which can alter/halt the disease progression.http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=6;spage=156;epage=166;aulast=Kediaesophageal dysmotilityfecal incontinencefibrosisgastroparesispseudoobstruction |
| spellingShingle | Saurabh Kedia Anuj Chhaparia Pramod Garg Gastro-intestinal involvement in systemic sclerosis Indian Journal of Rheumatology esophageal dysmotility fecal incontinence fibrosis gastroparesis pseudoobstruction |
| title | Gastro-intestinal involvement in systemic sclerosis |
| title_full | Gastro-intestinal involvement in systemic sclerosis |
| title_fullStr | Gastro-intestinal involvement in systemic sclerosis |
| title_full_unstemmed | Gastro-intestinal involvement in systemic sclerosis |
| title_short | Gastro-intestinal involvement in systemic sclerosis |
| title_sort | gastro intestinal involvement in systemic sclerosis |
| topic | esophageal dysmotility fecal incontinence fibrosis gastroparesis pseudoobstruction |
| url | http://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2017;volume=12;issue=6;spage=156;epage=166;aulast=Kedia |
| work_keys_str_mv | AT saurabhkedia gastrointestinalinvolvementinsystemicsclerosis AT anujchhaparia gastrointestinalinvolvementinsystemicsclerosis AT pramodgarg gastrointestinalinvolvementinsystemicsclerosis |