title: Evaluation and management of gastrointestinal manifestations in scleroderma.
abstract: OBJECTIVE
  The gastrointestinal tract is the most common extra-cutaneous organ system involved with systemic sclerosis (SSc) affecting approximately 90% of patients. This review summarizes the recent advances in the evaluation and management of gastrointestinal manifestations of SSc.
  
  
  RESULTS
  There is a growing body of evidence that uncontrolled GERD can play a significant role in the pathogenesis of SSc-associated interstitial lung disease. Newer forms of management of Barrett esophagus are showing significant promise as potentially curative therapy. Gastric antral vascular ectasias have strongly been associated with the presence of RNA polymerase III antibody. Newer technologies have advanced the assessment of gastrointestinal dysmotility in SSc. Evidence of probiotic use for the treatment of gastrointestinal complications is emerging. The UCLA SCTC GIT 2.0 questionnaire is being increasingly accepted by the SSc experts as a validated instrument for evaluation of patient-reported outcomes involving the gastrointestinal tract.
  
  
  CONCLUSIONS
  Our knowledge of the complex pathogenesis of gastrointestinal manifestations of SSc has expanded substantially in the last few decades. There has also been considerable technological progress in the evaluation of these manifestations. Patient care is being optimized by close collaboration of rheumatologists and gastroenterologists, leading to a more coordinated approach in the management of these complications.
authors.affiliation: aCenter for Human Nutrition, Digestive Disease Institute bDepartment of Rheumatic and Immunologic Diseases, Orthopedics and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Donald F
authors.initials: DF
authors.lastname: Kirby
authors.forename: Soumya
authors.initials: S
authors.lastname: Chatterjee
mesh_terms: D019468:Disease Management; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D041981:Gastrointestinal Tract / Q000473:pathology*; D006801:Humans; D012595:Scleroderma, Systemic / Q000150:complications* / Q000473:pathology