Upper gastrointestinal tract

Abstract

Systemic sclerosis (SSc) is a chronic connective tissue disorder with multisystem involvement. The gastrointestinal (GI) tract is affected in up to 90% of patients [1-3] and gut involvement is a leading cause of morbidity. Symptoms vary based on location of involvement and degree of impairment; however, dysphagia, reflux, nausea, vomiting, pain, diarrhea, constipation, fecal incontinence, and weight loss are commonly reported. GI involvement severely impacts quality of life and is a major cause of morbidity and mortality associated with SSc [4]. While the esophagus is the most widely described site of GI involvement, SSc can affect any site within the GI tract from the mouth to the anus. This chapter will focus on foregut manifestations of SSc, ranging from the mouth to stomach with an emphasis on both motility and bleeding. Involvement of other regions of the GI tract will be detailed in other chapters.