What are the GI manifestations of Systemic Sclerosis?
Upper GI tract: GERD (heartburn), hypomotility, dysphagia, nausea, stricture formation, risk of Barrett’s esophagus (10%–15%), gastric antral vascular ectasia (GAVE). Cough due to aspiration is a common symptom associated with GERD. Calcium channel blockers used to treat Raynaud’s can make GERD worse.
Lower GI tract: Hypomotility, bloating, nausea, small intestinal bacterial overgrowth (manifested by fluctuating constipation and diarrhea), malabsorption, intestinal pseudo-obstruction, pneumatosis coli, loss of rectal sphincter tone with resultant fecal incontinence, and rectal prolapse. Calcium channel blockers used to treat Raynaud’s phenomenon can make constipation worse.
