Skip to main content
SpringerLink
Log in

Constipation, Bloating and Abdominal Pain

  • Chapter
  • First Online:
Practical Management of Systemic Sclerosis in Clinical Practice

Part of the book series: In Clinical Practice ((ICP))

  • 393 Accesses

Abstract

Symptoms of constipation, abdominal pain and bloating are common among scleroderma patients. Differentiating between the underlying etiological factors and proposing a successful treatment strategy can be challenging. The following chapter deals with the management of these symptoms, both from a diagnostic and a therapeutic point. A clinical case and algorithms are also included.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kumar S, Singh J, Rattan S, DiMarino J, Cohen S, Jimenez SA. Review article: pathogenesis and clinical manifestations of gastrointestinal systemic sclerosis. Aliment Pharmacol Ther. 2017;45(7):883–98.

    Article  CAS  Google Scholar 

  2. Savarino E, Mei F, Parodi A, Ghio M, Furnari M, Gentile A, et al. Gastrointestinal motility disorder assessment in systemic sclerosis. Rheumatology. 2013;52(6):1095–100.

    Article  CAS  Google Scholar 

  3. Hansi N, Thoua N, Carulli M, Chakravarty K, Lal S, Smyth A, et al. Consensus best practice pathway of the UK scleroderma study group: gastrointestinal manifestations of systemic sclerosis. Clin Exp Rheumatol. 2014;32(6Suppl 86):S-214-21.

    PubMed  Google Scholar 

  4. Khanna D, Nagaraja V, Gladue H, Chey W, Pimentel M, Frech T. Measuring response in the gastrointestinal tract in systemic sclerosis. Curr Opin Rheumatol. 2013;25(6):00–6. doi: 10.1097/01

    Article  Google Scholar 

  5. Harrison E, Murray C, Lal S. Small and large intestinal involvement and nutritional issues. In: Varga J, Denton CP, Wigley FM, Allanore Y, Kuwana M, editors. Scleroderma: from pathogenesis to comprehensive management. New York: Springer; 2017. p. 443–58.

    Chapter  Google Scholar 

  6. Shreiner AB, Murray C, Denton C, Khanna D. Gastrointestinal manifestations in systemic sclerosis. J Scleroderma Relat Disord. 2016;1(3):247–56. https://doi.org/10.5301/jsrd.5000214.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Basilico G, Barbera R, Vanoli M, Bianchi P. Anorectal dysfunction and delayed colonic transit in patients with progressive systemic sclerosis. Dig Dis Sci. 1993;38:1525–9.

    Article  Google Scholar 

  8. Wald A. Is chronic use of stimulant laxatives harmful to the colon? J Clin Gastroenterol. 2003;36(5):386–9.

    Article  Google Scholar 

  9. Emmanuel AV, Tack J, Quigley EM, Talley NJ. Pharmacological management of constipation. Neurogastroenterol Motil. 2009;21(Suppl 2):41–54. https://doi.org/10.1111/j.1365-2982.

    Article  CAS  PubMed  Google Scholar 

  10. Boeckxstaens GE, Bartelsman JF, Lauwers L, Tytgat GN. Treatment of GI dysmotility in scleroderma with the new enterokinetic agent prucalopride. Am J Gastroenterol. 2002;97:194–7.

    Article  CAS  Google Scholar 

  11. Iovino P, Valentini G, Ciacci C, De Luca A, Tremolaterra F, Sabbatini F, et al. Proximal stomach function in systemic sclerosis: relationship with autonomic nerve function. Dig Dis Sci. 2001;46(4):723–30.

    Article  CAS  Google Scholar 

  12. Savarino E, Furnari M, de Bortoli N, Martinucci I, Bodini G, Ghio M, et al. Gastrointestinal involvement in systemic sclerosis. Presse Med. 2014;43(10 Pt 2):e279–91. https://doi.org/10.1016/j.lpm.2014.03.029.

    Article  PubMed  Google Scholar 

  13. Marie I, Ducrotte P, Denis P, Menard JF, Levesque H. Small intestinal bacterial overgrowth in systemic sclerosis. Rheumatology. 2009;48(10):1314–9. https://doi.org/10.1093/rheumatology/kep226.

    Article  PubMed  Google Scholar 

  14. Bures J, Cyrany J, Kohoutova D, Förstl M, Rejchrt S, Kvetina J, et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010;16(24):2978–90.

    Article  CAS  Google Scholar 

  15. Muangchan C, Canadian Scleroderma Research Group, Baron M, Pope J. The 15% rule in scleroderma: the frequency of severe organ complications in systemic sclerosis. A systematic review. J Rheumatol. 2013;40(9):1545–56. https://doi.org/10.3899/jrheum.121380.

    Article  PubMed  Google Scholar 

  16. Nagaraja V, McMahan ZH, Getzug T, Khanna D. Management of gastrointestinal involvement in scleroderma. Curr Treatm Opt Rheumatol. 2015;1(1):82–105.

    Article  Google Scholar 

  17. Romagnuolo J, Schiller D, Bailey RJ. Using breath tests wisely in a gastroenterology practice: an evidence-based review of indications and pitfalls in interpretation. Am J Gastroenterol. 2002;97(5):1113–26.

    Article  Google Scholar 

  18. Khoshini R, Dai SC, Lezcano S, Pimentel M. A systematic review of diagnostic tests for small intestinal bacterial overgrowth. Dig Dis Sci. 2008;53(6):1443–54.

    Article  Google Scholar 

  19. Braun-Moscovici Y, Braum M, Khanna D, Balbir-Gurman A, Furst DE. What tests should you use to assess small intestinal bacterial overgrowth in systemic sclerosis? Clin Exp Rheumatol. 2015;33(4 Suppl 91):S117–22.

    PubMed  Google Scholar 

  20. Marie I, Leroi AM, Menard JF, Levesque H, Quillard M, Ducrotte P. Fecal calprotectin in systemic sclerosis and review of the literature. Autoimmun Rev. 2015;14(6):547–54. https://doi.org/10.1016/j.autrev.2015.01.018.

    Article  CAS  PubMed  Google Scholar 

  21. Kaye SA, Lim SG, Taylor M, Patel S, Gillespie S, et al. Small bowel bacterial overgrowth in systemic sclerosis: detection using direct and indirect methods and treatment outcome. Br J Rheumatol. 1995;34:265–9.

    Article  CAS  Google Scholar 

  22. Frech TM, Mar D. Gastrointestinal and hepatic disease in systemic sclerosis. Rheum Dis Clin N Am. 2018;44(1):15–28.

    Article  Google Scholar 

  23. McFarlane IM, Bharma MS, Kreps A, Iqbal S, Al-Ani F, Saladini-Aponte C, et al. Gastrointestinal manifestations of systemic sclerosis. Rheumatology. 2018;8(1). pii: 235 https://doi.org/10.4172/2161-1149.1000235.

  24. Baron M, Bernier P, Cote LF, Delegge MH, Falovitch G, Friedman G, et al. Screening and therapy for malnutrition and related gastro-intestinal disorders in systemic sclerosis: recommendations of a north American expert panel. Clin Exp Rheumatol. 2010;28(2 Suppl 58):S42–6.

    PubMed  Google Scholar 

  25. Gatta L, Scarpignato C. Systematic review with meta-analysis: rifaximin is effective and safe for the treatment of small instestine bacterial overgrowth. Aliment Pharmacol Ther. 2017;45(5):604–6016.

    Article  CAS  Google Scholar 

  26. Frech TM, Khanna D, Maranian P, Frech EJ, Sawitzke AD, Murtaugh MA. Probiotics for the treatment of systemic sclerosis-associated gastrointestinal bloating/ distention. Clin Exp Rheumatol. 2011;29(2 Suppl 65):S22–5.

    PubMed  Google Scholar 

  27. Nikou GC, Toumpanakis C, Katsiari C, Charalambopoulos D, Sfikakis PP. Treatment of small intestinal disease in systemic sclerosis with octreotide: a prospective study in seven patients. J Clin Rheumatol. 2007;13(3):119–23.

    Article  Google Scholar 

  28. Perlemuter G, Cacoub P, Chaussade S, Wechsler B, Couturier D, Piette JC. Octreotide treatment of chronic intestinal pseudoobstruction secondary to connective tissue diseases. Arthritis Rheum. 1999;42(7):1545–9.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Royal Free London NHS Foundation Trust and Institute of Liver and Diigestive Health, University College London, London, UK

    Stamatia-Lydia Chatzinikolaou & Charles Murray

Authors
  1. Stamatia-Lydia Chatzinikolaou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charles Murray
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles Murray .

Editor information

Editors and Affiliations

  1. University of Florence, Firenze, Firenze, Italy

    Marco Matucci-Cerinic

  2. University College London, Royal Free Hospital, London, UK

    Christopher P. Denton

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chatzinikolaou, SL., Murray, C. (2021). Constipation, Bloating and Abdominal Pain. In: Matucci-Cerinic, M., Denton, C.P. (eds) Practical Management of Systemic Sclerosis in Clinical Practice. In Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-53736-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-53736-4_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-53735-7

  • Online ISBN: 978-3-030-53736-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation