Gastrointestinal symptoms of systemic sclerosis 4.4/5 (5)

Share Button

Definition

The gastrointestinal tract extends between the mouth and rectal opening. By Systemic sclerosis The whole 90% has one or more symptoms from this area. Some symptoms can be remedied by dietary measures, others need medications and other treatments.

Oral cavity

Dry mouth in the mucous membrane occurs (as if Sjögren's syndrome) due to reduced saliva production. More information about symptoms of the mouth and teeth of systemic sclerosis here.

Esophagus

Up to 90% have reduced function in Esophagus (esophagus) with impact on the peristalsis. This especially includes the lower 1 / 3 of the esophagus.

  • Symptoms include that the food "gets stuck" after swallowing
  • Reduced peristalsis is detected by X-ray with swallowing contrast media and film or manometry

Impaired closing function (sphincter) between the esophagus and stomach causes stomach acid to easily reach the esophagus (Gastro-oesophagal reflux) where the acid causes damage to the mucous membranes

  • Symptoms can be worse when lying flat
  • Acid production inhibitor (PPIs) tablets (such as Somac) have effect
  • Operation (ear-nose-throat physician) is required in some cases

Stomach

  • Gastric anterior venous ectasia (GAVE) occur in the diffuse form of systemic sclerosis, most commonly during the first two years of the disease
    • Symptoms are pain and bleeding from the stomach ("pain at the middle floor"
    • Blood samples show falling hemoglobin
    • Gastroscopy is required for medical examination, preferably in hospitals with experience with the disease
    • The treatment is included Argon laser which "burns" / "coagulates" blood vessels in the stomach mucosa so that bleeding gradually stop and rarely returns

Small intestine

Symptoms are from small intestine are frequent loose stools, reduced nutritional uptake and bloating

Reduced uptake of nutrition

  • Reduced intake of nutrients (malabsorption) may be caused by reduced function of the small intestine and present at 10-30% with systemic sclerosis
  • Reduced mobility in the intestine causes abnormal bacterial growth in the intestine (Bacterial overgrowth) Of 20-30%

Bacterial overgrowth

  • Bacterial overgrowth may cause
    • Bloating (meteorism)
    • Pain
    • Periodically loose, malodorous stools
    • Weight Loss
  • Treatment of bacterial overgrowth can be with antibiotic cures, but antibiotic resistance can be a problem

Pneumatosis cystoids intestinalis

  • Air in the intestinal tract (pneumatosis cystoids intestinalis) with perforation (puncture) into the abdominal cavity may occur
    • Air in the intestinal wall is detected by CT examination of the abdominal region where air cysts in the intestinal wall and "free air" in the abdominal cavity are detected
    • Usually, no perforation exists throughout the intestinal wall. Operation is usually not required
    • The condition is treated with antibiotics, fluids and electrolytes intravenously. Hyperbaric or normobar oxygen delivery has also been reported effectively

Biopsy

  • Disease changes in the small intestine can also be detected by biopsy (tissue test), but are not common to implement. Biopsy is made if the diagnosis is uncertain and other diseases (Celiac Disease, Whipples disease) may be excluded

Liver and gall system

Primary biliary cirrhosis is seen at the same time as systemic sclerosis

Pancreas

Pancreas (pancreas) rarely attacked by systemic sclerosis

The colon

Colon (kolon) gives symptoms of 10-50% with systemic sclerosis

  • Rectum is causing most of the symptoms
  • Problems with Fecal incontinence can come quite early in the course of illness and be socially very problematic
  • MRI examination may show changes in the rectum and closure muscles
  • Manometry (measuring the muscle function of the rectum) can detect reduced or absent closure of the reflexes (as in the gastrointestinal mucosa and esophagus). The reason is changes in the nerves in the areas
  • Constipation ("Hard stools") is often defined as less than two stool per week and are common in systemic sclerosis. The reason is reduced mobility in the intestine. Loose stools are more common for small intestine (please see above)

Systemic sclerosis, BINDEVEVSSYKDOMMER.no

Literature


This page has had 5 visits today

Please rate this page