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Gastrointestinal involvement in systemic sclerosis

an update

McMahan, Zsuzsanna H.

Current Opinion in Rheumatology: November 2019 - Volume 31 - Issue 6 - p 561–568
doi: 10.1097/BOR.0000000000000645

Purpose of review This review provides important updates in systemic sclerosis (SSc)-related gastrointestinal disease, specifically focusing on the most recent literature.

Recent findings In the past year, several studies were published that present interesting insights into SSc and gastrointestinal disease. Studies focusing on newly identified risk factors, novel approaches to diagnosis and assessment of disease activity, survival and quality of life demonstrate progress in our understanding of this challenging area. Additional data on specific SSc gastrointestinal-related topics, such as the link between gastrointestinal and pulmonary disease, nutrition, and the microbiome, are also now available.

Summary SSc gastrointestinal disease is heterogeneous in its clinical presentation, which presents a challenge in diagnosis and management. In the past year, several studies have evaluated risk factors and clinical features associated with specific gastrointestinal complications in SSc. Objective gastrointestinal testing may help to identify specific SSc gastrointestinal subgroups and provide diagnostic accuracy to guide targeted therapies. Survival in very early SSc is affected by the severity of gastrointestinal involvement. Other important gastrointestinal subsets, including patients with esophageal disease and interstitial lung disease, should carefully be considered when developing a management plan for this patient population.

Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Correspondence to Zsuzsanna H. McMahan, MD, MHS, 5200 Eastern Avenue, Suite 5200, Mason F Lord Building, Center Tower, Baltimore, MD 21224, USA. Tel: +1 410 550 2003; fax: +1 410 550 2072; e-mail:

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