Title: Systemic Sclerosis - Musculoskeletal and Connective Tissue Disorders - Merck Manuals Professional Edition
Headings: Systemic Sclerosis
Systemic Sclerosis
(Scleroderma)
Classification of Systemic Sclerosis
Etiology of Systemic Sclerosis
Pathophysiology of Systemic Sclerosis
Symptoms and Signs of Systemic Sclerosis
Skin and nail manifestations
Skin Manifestations of Systemic Sclerosis
Joint manifestations
Elbow Contracture in Systemic Sclerosis
Gastrointestinal manifestations
Cardiopulmonary manifestations
Renal manifestations
Diagnosis of Systemic Sclerosis
Antinuclear Antibody (ANA)
Dilated Capillary Loops
Capillaroscopy
Prognosis of Systemic Sclerosis
Prognosis reference
Treatment of Systemic Sclerosis
Treatment references
Key Points about Systemic Sclerosis
Drugs Mentioned In This Article
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Content: Gastrointestinal manifestations
Esophageal dysfunction is the most frequent visceral disturbance and occurs in most patients. Dysphagia (usually retrosternal) usually develops first. Acid reflux can cause heartburn and stricture. Barrett esophagus occurs in one third of patients and predisposes to complications (eg, adenocarcinoma). Hypomotility of the small bowel causes bacterial overgrowth that can lead to malabsorption. Air may penetrate the damaged bowel wall and be visible on x-rays (pneumatosis intestinalis). Leakage of bowel contents into the peritoneal cavity can cause peritonitis. Distinctive wide-mouthed diverticula can develop in the colon. Biliary cirrhosis may develop in patients with limited systemic sclerosis (CREST syndrome). Cardiopulmonary manifestations
Lung involvement generally progresses indolently, with substantial individual variability, but is a common cause of death.