Skip to main content

Advertisement

SpringerLink
Log in

Profile of gastrointestinal involvement in patients with systemic sclerosis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disease. Of the numerous organ manifestations, involvement of the upper and lower gastrointestinal tract (GIT) appears to be the most frequent with regard to the clinical symptoms. However, as the frequency and clinical relevance of GI involvement in patients with SSc are not known in detail, the German network of the systemic sclerosis (DNSS) has developed a detailed questionnaire to evaluate the extent and profile of gastrointestinal involvement in SSc patients. The multi-symptom questionnaire was used at baseline and after 1 year in registered patients of the DNSS. In addition, the results were compared with gastrointestinal disorders in patients with SSc and other rheumatic diseases, as well as with the medical history of the patients. In total, 90 patients were included in the study. The results of the study show that in reality, a much higher (nearly all) percentage of (98,9%) patients than expected suffer from GI-symptoms, regardless of the stage of their disease. Of these, meteorism (87,8%) was the most common followed by coughing/sore voice (77,8%), heartburn (daytime 68,9%, nighttime 53,3%), diarrhea (67,8%), stomach ache (68,9%) and nausea (61,1%). Although SSc patients were treated according to the respective recommendations, only limited improvements with regard to GI-symptoms could be achieved after 1 year of follow-up. In addition, the study revealed that the multi-symptom questionnaire is a useful tool to contribute to identify the gastrointestinal sequelae in systemic sclerosis.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Mayes MD, Lacey JV, Beebe-Dimmer J, Gillespie BW, Cooper B, Laing TJ et al (2003) Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population. Arthritis Rheum 48:2246–2255

    Article  PubMed  Google Scholar 

  2. Seibold JR (2005) In: Harris ED Jr, Budd RC, Firestein GS, Genovese MC, Sergent JS, Ruddy S, Sledge CB (eds) Kelley`s textbook of rheumatology, vol II, 7th edn. Elsevier Saunders, Philadelphia, pp 1279–1308

  3. Manetti M, Neumann E, Milla AF, Tarner IH, Bechi P, Matucci-Cerinic M et al (2007) Severe fibrosis and increased expression of fibrogenic cytokines in the gastric wall of systemic sclerosis patients. Arthritis Rheum 56:3442–3447

    Article  PubMed  Google Scholar 

  4. Szamosi S, Szekanecz Z, Szücs G (2006) Gastrointestinal manifestations in Hungarian scleroderma patients. Rheumatol Int 26:1120–1124

    Article  PubMed  Google Scholar 

  5. Masi AT, Rodnan GP, Medsger TA, Altman RD, D`Angelo WA, Fries JF et al (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590

    Article  Google Scholar 

  6. Alarcón-Segovia D, Villareal M (1987) Classification and diagnostic criteria for MCTD. In: Kasukawa R, Sharp GC (eds) Mixed connective tissue disease and anti-nuclear antibodies. Elsevier, Amsterdam, pp 33–40

    Google Scholar 

  7. Jaovisidha K, Csuka ME, Almagro UA, Soergel KH (2005) Severe gastrointestinal involvement in systemic sclerosis: a report of five cases and review of the literature. Semin Arthritis Rheum 34:689–702

    Article  PubMed  Google Scholar 

  8. Khanna D, Hays RD, Park GS, Braun-Moscovici Y, Mayes MD, McNearney TA et al (2007) Development of a preliminary scleroderma gastrointestinal tract 1.0 quality of life instrument. Arthritis Rheum 57:1280–1286

    Article  PubMed  Google Scholar 

  9. Czirjak L, Pakozdi A, Kumanovics G, Varju C, Nagy Z, Szekanecz Z et al (2007) Survival and causes of death in 366 Hungarian patients with systemic sclerosis. Ann Rheum Dis 67:59–63

    Article  PubMed  Google Scholar 

  10. Cohen S, Fisher R, Lipshutz W, Turner R, Myers A, Schumacher R (1972) The pathogenesis of esophageal dysfunction in scleroderma and Raynaud′s disease. J Clin Invest 51:2663–2668

    Article  PubMed  CAS  Google Scholar 

  11. Saar P, Schmeiser T, Tarner IH, Müller-Ladner U (2007) Gastrointestinal involvement in systemic sclerosis. Hautarzt 58:844–850

    Article  PubMed  CAS  Google Scholar 

  12. Sjögren RW (1996) Gastrointestinal features of scleroderma. Curr Opin Rheumatol 8:569–575

    Article  PubMed  Google Scholar 

  13. Weber P, Ganser G, Frosch M, Roth J, Hülskamp G, Zimmer KP (2000) Twenty-four hour intraesophageal pH monitoring in children and adolescents with scleroderma and mixed connective tissue disease. J Rheumatol 27:2692–2695

    PubMed  CAS  Google Scholar 

  14. Sjögren RW (1994) Gastrointestinal motility disorders in scleroderma. Arthritis Rheum 37:1265–1282

    Article  PubMed  Google Scholar 

  15. Chung L, Krishan E, Chakravarty EF (2007) Hospitalizations and mortality in systemic sclerosis: results from the nationwide inpatient sample. Rheumatology 46:1808–1813

    Article  PubMed  CAS  Google Scholar 

  16. Wang SJ, Lan JL, Chen DY, Chen YH, Hsieh TY, Lin WY (2001) Effects of cisapride on colonic transit in patients with progressive systemic sclerosis. Clin Rheumatol 21:271–274

    Article  Google Scholar 

  17. Walker UA, Tyndall A, Czirjak L, Denton C, Farge-Bancel D, Kowal-Bielecka O et al (2007) Clinical risk assessment of organ manifestations in systemic sclerosis: a report from the EULAR scleroderma trials and research (EUSTAR) group database. Ann Rheum Dis 66:754–763

    Article  PubMed  CAS  Google Scholar 

  18. Caserta L, de Magistris L, Secundolfo M, Caravelli G, Riegler G, Cuomo G et al (2003) Assessment of intestinal permeability and orocecal transit time in patients with systemic sclerosis: analysis of relationships with epidemiologic and clinical parameters. Rheumatol Int 23:226–230

    Article  PubMed  Google Scholar 

  19. Franck-Larsson K, Hedenström H, Dahl R, Rönnblom A (2003) Delayed gastric emptying in patients with diffuse versus limited systemic sclerosis, unrelated to gastrointestinal symptoms and myoelectric gastric activity. Scand J Rheumatol 32:348–355

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This work was supported by the German Network for systemic sclerosis (DNSS), funded by an initiative of the German Ministry of Education and Research (BMBF).

Author information

Authors and Affiliations

  1. Department of Rheumatology and Immunology, Kerckhoff-Clinic Bad Nauheim, Benekestr. 2- 8, 61231, Bad Nauheim, Germany

    T. Schmeiser & U. Müller-Ladner

  2. Department of Cardiology, Clinic of Hanau, Hanau, Germany

    P. Saar

  3. Department of Internal Medicine and Rheumatology, Justus-Liebig-University Gießen, Gießen, Germany

    D. Jin & U. Müller-Ladner

  4. Department of Endocrinology and Gastroenterology, Justus-Liebig-University Gießen, Gießen, Germany

    M. Noethe, N. Soydan, P. D. Hardt & R. G. Bretzel

  5. Department of Internal Medicine, University Regensburg, Regensburg, Germany

    A. Müller

  6. Department of Internal Medicine, Main Taunus Clinic Bad Soden, Bad Soden, Germany

    C. Jaeger

  7. Department of Rheumatology and Institute of Physical Medicine, University Hospital Zürich, Zürich, Switzerland

    O. Distler

  8. Department of Pneumology and Gastroenterology, Justus-Liebig-University Gießen, Gießen, Germany

    E. Roeb

Authors
  1. T. Schmeiser
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Saar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Noethe
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N. Soydan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. D. Hardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C. Jaeger
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. O. Distler
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. E. Roeb
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. R. G. Bretzel
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. U. Müller-Ladner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Schmeiser.

Additional information

For the German Network for Systemic Sclerosis (DNSS).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schmeiser, T., Saar, P., Jin, D. et al. Profile of gastrointestinal involvement in patients with systemic sclerosis. Rheumatol Int 32, 2471–2478 (2012). https://doi.org/10.1007/s00296-011-1988-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-1988-6

Keywords

Search

Navigation