Scleroderma and Gastrointestinal Problems

Most people living with scleroderma have mild to severe gastrointestinal problems. Gastrointestinal symptoms in scleroderma can appear in many forms and involve different levels of risk, from simple indigestion to esophageal blockage.

The gastrointestinal (GI) tract in our body is involved in consuming and processing the food we eat and eliminating waste. In scleroderma, fibrosis (scarring) makes the walls of the gut thicker and the muscles don’t work as effectively. This affects the way food is moved through your body and digested and causes digestive problems.

More than 90% of those living with scleroderma experience some form of GI issues. Severe gastrointestinal scleroderma complications are serious and affect only about 10% of people with scleroderma. Fortunately, most GI symptoms can be managed with help from your healthcare team.

Scleroderma Gastrointestinal Symptoms

Other GI symptoms scleroderma patients may have include:

• Stomach Pain
• Difficulty swallowing, and acid reflux
• Nausea
• Heartburn or indigestion.
• Changes in appetite.
• Constipation.
• Diarrhea
• Vomiting
• Bloating
• Fecal incontinence

Problems with the esophagus that result in swallowing difficulties and heartburn are the most common risks among people with scleroderma. Other risks can include:

• Gastroesophageal reflux disease or GERD. It is also called acid reflux disease, acid indigestion, or heartburn. It occurs when stomach acids back up into the esophagus and cause irritation. With reflux, a person may inhale stomach acids into the lungs. This is irritating to the lungs and can complicate lung disease.
• Abnormal cell growth can damage the esophagus. This can cause swallowing difficulties. It can affect how well the esophagus moves food to the stomach. In severe cases may cause blockage or increase the risk of esophageal cancer.
• Damage to the intestines hinders the absorption of nutrients. It may cause substantial weight loss and malnutrition.

Treatments for gastrointestinal complications in scleroderma

The GI system is complex. Treating GI symptoms is important but diagnosis and treatment will differ according to the location of the symptom or problem. Early recognition of gastrointestinal scleroderma is key to symptomatic control and complications prevention.

There are certain foods you may want to avoid in order to reduce scleroderma related gastrointestinal symptoms like acid reflux and heartburn, although experimentation may be needed to determine which food triggers symptoms.

• Alcohol
• Caffeine, coffee (regular and decaf)
• Chocolate
• Acidic foods (citrus fruits like oranges, tomato sauce)
• Fried foods
• Raw vegetables
• Foods with high fat content (fast foods, nuts, dairy products)
• Spicy foods
• Onions

Many people with gastrointestinal symptoms due to scleroderma are at risk for malnutrition. Regular assessment of nutritional status should be part of the gastrointestinal treatment plan.