Gastrointestinal involvement in systemic sclerosis: diagnostic and therapeutic aspects
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 2
Abstract
Systemic sclerosis (SSc) is a rare autoimmune disorder that carries a high morbidity and mortality. It is characterized by fibrosis of multiple organs including skin, musculoskeletal system, the lungs, kidneys, heart and gastrointestinal (GI) tract. Among those organs, GI tract is the most commonly affected where up to 90 % of SSc patients have GI involvement. Pathogenetic mechanisms implicated in this disease include endothelial damage, vasculopathy and cytokine release triggering immune response, collagen deposition and ultimately fibrosis, the hallmark of the disease. Clinical manifestations of the disease, including dysmotility, hypotension, rigidity of the walls and muscle atrophy, resulting in paresis, dilatation, excessive growth of intestine bacteria, chronic intestinal pseudo-obstruction, diarrhea, constipation. The esophagus is the most commonly affected part of the GI tract, manifested by gastroesophageal reflux disease, esophagitis, risk of interstitial lung disease and Barret’s esophagus, the latter necessitating close surveillance for early detection of malignant transformation. The management options for the GI manifestations of SSc are far from ideal given the short-term efficacy and limiting side effects; these include proton pomp inhibitors, prokinetics, antibiotics and various endoscopic interventions. Further research is needed to identify therapeutic modalities that arrest the fibrotic process early in the disease, thus preventing complications and permanent damage to vital organs. Disease modifying antirheumatic drugs have no benefit and effect in GI tract lesions in SSc.
Authors and Affiliations
I. Yu. Golovach, Ye. D. Yehudina
Keywords
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- EP ID EP575186
- DOI 10.30978/MG-2019-2-99
- Views 104
- Downloads 0
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