GASTROINTESTINAL MANIFESTATIONS OF SCLERODERMA

Up to 90% of patients with scleroderma have involvement of the gastroi ntestinal system. The esophagus is the most frequently affected, follo wed by the anorectal region, the small bowel, stomach, and colon. Smoo th muscle atrophy and to a lesser degree fibrosis are the underlying d efects responsible for the resulting abnormalities. These smooth muscl e alterations have a significant impact on gastrointestinal motility, which results in a variety of secondary disorders, including gastroeso phageal reflux disease and its complications, pseudo-obstruction, bact erial overgrowth, disordered bowel movements, and incontinence. These manifestations are common causes of morbidity and, in rare cases, mort ality. This article reviews the clinical symptoms, pathophysiology, di agnosis, and management of gastrointestinal disease in progressive sys temic sclerosis (SSc).