[Digestive manifestations in systemic sclerosis].
Gastrointestinal involvement occurs in most patients with systemic sclerosis. Pathology is characterized by vasculopathy, resulting in tissue ischemia, progressive dysfunction and fibrosis. In its diffuse and visceral pattern, digestive manifestations may involve most of the intestinal tract and are the most frequent before renal, cardiac and pulmonary involvement. Whatever the visceral extension, about 80% of patients have digestive manifestations including gastroesophageal reflux, abnormalities of intestinal motility leading to chronic intestinal pseudo-obstruction and small bowel bacterial overgrowth and malnutrition. Long-term treatment of reflux with high-dose proton pump inhibitors appears safe and effective for symptom relief and may prevent recurrence of esophagitis and stricture. Prokinetic agents effective in pseudoobstruction include metoclopramide, domperidone, octreotide, and erythromycin.
Attar
Alain
A
Service d'Hépato-Gastroentérologie et d'Assistance Nutritive, Hôpital Lariboisière, 2, rue Ambroise-Paré, 75475 Paris Cedex 10, France. alain.attar@avc.ap-hop-paris.fr
D004064:Digestive System / Q000098:blood supply*; D004066:Digestive System Diseases / Q000209:etiology* / Q000473:pathology; D018450:Disease Progression; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005355:Fibrosis; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000628:therapy; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D007511:Ischemia / Q000209:etiology*; D009748:Nutrition Disorders / Q000209:etiology; D054328:Proton Pump Inhibitors; D012595:Scleroderma, Systemic / Q000150:complications*
D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors