Gastrointestinal manifestations of scleroderma.

The gastrointestinal tract is commonly involved in SSc. The esophagus is the most frequently affected, followed by the anorectal region, the small bowel, stomach, and colon. Smooth muscle atrophy and to a lesser degree fibrosis is the underlying defect responsible for the resulting abnormalities. These smooth muscle alterations have a significant impact on gastrointestinal motility, which results in secondary disorders of GER, pseudo-obstruction, bacterial overgrowth, and disordered bowel functions. The clinical presentation for these conditions ranges from asymptomatic to life-threatening. Thus, gastrointestinal evaluation and treatment of these conditions is an important aspect in the management of patients with SSc.