Screening and therapy for malnutrition and related gastro-intestinal disorders in systemic sclerosis: recommendations of a North American expert panel.
OBJECTIVE
To develop a set of recommendations for clinicians caring for patients with systemic sclerosis (SSc) to guide their approach to the patient with malnutrition and possible malabsorption.


METHODS
The Canadian Scleroderma Research Group convened a meeting of experts in the areas of nutrition, speech pathology, oral health in SSc, SSc and gastroenterology to discuss the nutrition-GI paradigm in SSc. This meeting generated a set of recommendations based on expert opinion.


RESULTS
Physicians should screen ALL patients with SSc for malnutrition. The physician should ask a series of questions that pertain to GI involvement. Patients who screen positive for malnutrition should be referred to a dietitian and gastroenterologist. Referral to a patient support group should be considered and if screening reveals oral health problems, referral to a dentist, preferably with expertise in treating patients with SSc, should be done. All SSc patients should weigh themselves monthly and report any sudden significant changes in weight. They should be assessed by a rheumatologist once a year for signs of malnutrition.


CONCLUSIONS
Malnutrition may be common in SSc and a multidisciplinary approach is important.
Baron
Murray
M
Jewish General Hospital and McGill University, Montreal, Canada. mbaron@rhu.jgh.mcgill.ca
Bernier
Paule
P
Côté
Louis-François
LF
Delegge
Mark H
MH
Falovitch
Glenda
G
Friedman
Gad
G
Gornitsky
Mervyn
M
Hoffer
John
J
Hudson
Marie
M
Khanna
Dinesh
D
Paterson
William G
WG
Schafer
Donna
D
Toskes
Phillip P
PP
Wykes
L
L
D006801:Humans; D007400:Interprofessional Relations; D008286:Malabsorption Syndromes / Q000209:etiology / Q000628:therapy*; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology; D008403:Mass Screening; D009656:North America; D009752:Nutritional Status; D012595:Scleroderma, Systemic / Q000150:complications*; D011795:Surveys and Questionnaires