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Gastrointestinal Manifestations of Rheumatological Diseases

Kröner, Paul T. MD, MSc1; Tolaymat, Omar A. MD2; Bowman, Andrew W. MD, PhD3; Abril, Andy MD2; Lacy, Brian E. MD, PhD, FACG1

doi: 10.14309/ajg.0000000000000260

Rheumatological diseases (RDs) represent a diverse group of diseases that are inherited or related to environmental factors. RDs frequently affect the gastrointestinal (GI) tract, and gastroenterologists are often asked to evaluate patients with symptoms thought to represent an underlying or coexisting RD. GI manifestations of RDs vary based on the organ involved as well as the extent and duration of involvement. Although most manifestations of RD are nonspecific and not life-threatening, the chronicity and severity of symptoms can be debilitating and may lead to serious injury. This narrative review discusses the most common RD encountered by gastroenterologists: systemic lupus erythematosus, systemic sclerosis (scleroderma), dermatomyositis/polymyositis, rheumatoid arthritis, Sjögren syndrome, overlap syndromes, mixed connective tissue disease, Ehlers-Danlos syndromes, and other vasculitides. Each section begins with a brief overview of the condition, followed by a discussion of the etiopathophysiology, physical examination findings, GI manifestations, diagnostic tools (i.e., serologic, imaging, endoscopic, and functional), and treatment options.

1Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA;

2Division of Rheumatology, Mayo Clinic, Jacksonville, Florida, USA;

3Division of Radiology, Mayo Clinic, Jacksonville, Florida, USA.

Correspondence: Paul T. Kröner, MD, MSc. E-mail:

Received August 14, 2018

Accepted May 12, 2019

© The American College of Gastroenterology 2019. All Rights Reserved.
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