Title: Systemic scleroderma - Wikipedia
Headings: Systemic scleroderma
Systemic scleroderma
Contents
Signs and symptoms
Skin symptoms
Other organs
Musculoskeletal
Lungs
Digestive tract
Kidneys
Causes
Pathophysiology
Diagnosis
Treatment
Topical/symptomatic
Kidney disease
Lung disease
Other
Epidemiology
Society and culture
Support groups
Prognosis
Research
References
External links

Content: The most common manifestation in the esophagus is reflux esophagitis, which may be complicated by esophageal strictures or benign narrowing of the esophagus. This is best initially treated with proton pump inhibitors for acid suppression, but may require bougie dilatation in the case of stricture. Scleroderma can decrease motility anywhere in the gastrointestinal tract. The most common source of decreased motility is the esophagus and the lower esophageal sphincter, leading to dysphagia and chest pain. As scleroderma progresses, esophageal involvement from abnormalities in decreased motility may worsen due to progressive fibrosis (scarring). If this is left untreated, acid from the stomach can back up into the esophagus, causing esophagitis and Gastroesophageal reflux disease. Further scarring from acid damage to the lower esophagus many times leads to the development of fibrotic narrowing, also known as strictures, which can be treated by dilatation, and Barrett's esophagus. In patients with neuromuscular disorders, particularly progressive systemic sclerosis and visceral myopathy, the duodenum is frequently involved. Dilatation may occur, which is often more pronounced in the second, third, and fourth parts. The dilated duodenum may be slow to empty, and the grossly dilated, atonic organ may produce a sump effect.