GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: CLINICAL INSIGHTS AND EMERGING THERAPIES

Systemic sclerosis (SSc) is a chronic autoimmune disorder characterized by fibrosis of the skin and internal organs, microvascular injury, and immune system dysregulation. Among its extracutaneous manifestations, gastrointestinal (GI) involvement is one of the most common and debilitating, affecting...

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Main Authors: Dana Bekaryssova, Gulmira Mutalipova
Format: Article
Language:English
Published: South Kazakhstan Medical Academy 2025-06-01
Series:Central Asian Journal of Medical Hypotheses and Ethics
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Online Access:https://cajmhe.com/index.php/journal/article/view/459
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author Dana Bekaryssova
Gulmira Mutalipova
author_facet Dana Bekaryssova
Gulmira Mutalipova
author_sort Dana Bekaryssova
collection DOAJ
description Systemic sclerosis (SSc) is a chronic autoimmune disorder characterized by fibrosis of the skin and internal organs, microvascular injury, and immune system dysregulation. Among its extracutaneous manifestations, gastrointestinal (GI) involvement is one of the most common and debilitating, affecting up to 90% of patients during the disease course. GI symptoms may precede cutaneous changes and can significantly impair quality of life and prognosis. This narrative review summarizes the current understanding of the pathogenesis, clinical presentation, and management of GI involvement in SSc. The underlying mechanisms include vascular damage, immune activation, neural dysfunction, smooth muscle atrophy, and progressive fibrosis. These contribute to a wide range of motility disorders, such as esophageal dysmotility, gastroesophageal reflux disease (GERD), gastroparesis, intestinal pseudo-obstruction, and anorectal dysfunction. Additionally, small intestinal bacterial overgrowth (SIBO) and malabsorption are common complications that may lead to nutritional deficiencies and sarcopenia. In severe cases, total parenteral nutrition may become necessary. Despite its high prevalence and clinical impact, GI involvement in SSc remains frequently underrecognized and inadequately managed. Early detection, a multidisciplinary approach, and personalized treatment strategies are essential to improving patient outcomes. This review highlights the need for greater clinical awareness and continued research into targeted therapies that address the multifactorial pathophysiology of GI manifestations in systemic sclerosis.
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spelling doaj-art-892c010e6cf04be695e34b9f6bbb2c8f2025-08-20T03:28:41ZengSouth Kazakhstan Medical AcademyCentral Asian Journal of Medical Hypotheses and Ethics2708-98002025-06-016210511210.47316/cajmhe.2025.6.2.03459GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: CLINICAL INSIGHTS AND EMERGING THERAPIESDana Bekaryssova0Gulmira Mutalipova1Department of Chemical Disciplines, Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, KazakhstanDepartment of Chemical Disciplines, Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, KazakhstanSystemic sclerosis (SSc) is a chronic autoimmune disorder characterized by fibrosis of the skin and internal organs, microvascular injury, and immune system dysregulation. Among its extracutaneous manifestations, gastrointestinal (GI) involvement is one of the most common and debilitating, affecting up to 90% of patients during the disease course. GI symptoms may precede cutaneous changes and can significantly impair quality of life and prognosis. This narrative review summarizes the current understanding of the pathogenesis, clinical presentation, and management of GI involvement in SSc. The underlying mechanisms include vascular damage, immune activation, neural dysfunction, smooth muscle atrophy, and progressive fibrosis. These contribute to a wide range of motility disorders, such as esophageal dysmotility, gastroesophageal reflux disease (GERD), gastroparesis, intestinal pseudo-obstruction, and anorectal dysfunction. Additionally, small intestinal bacterial overgrowth (SIBO) and malabsorption are common complications that may lead to nutritional deficiencies and sarcopenia. In severe cases, total parenteral nutrition may become necessary. Despite its high prevalence and clinical impact, GI involvement in SSc remains frequently underrecognized and inadequately managed. Early detection, a multidisciplinary approach, and personalized treatment strategies are essential to improving patient outcomes. This review highlights the need for greater clinical awareness and continued research into targeted therapies that address the multifactorial pathophysiology of GI manifestations in systemic sclerosis.https://cajmhe.com/index.php/journal/article/view/459systemic sclerosisgastrointestinal tractdigestive systemalimentary tract
spellingShingle Dana Bekaryssova
Gulmira Mutalipova
GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: CLINICAL INSIGHTS AND EMERGING THERAPIES
Central Asian Journal of Medical Hypotheses and Ethics
systemic sclerosis
gastrointestinal tract
digestive system
alimentary tract
title GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: CLINICAL INSIGHTS AND EMERGING THERAPIES
title_full GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: CLINICAL INSIGHTS AND EMERGING THERAPIES
title_fullStr GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: CLINICAL INSIGHTS AND EMERGING THERAPIES
title_full_unstemmed GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: CLINICAL INSIGHTS AND EMERGING THERAPIES
title_short GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS: CLINICAL INSIGHTS AND EMERGING THERAPIES
title_sort gastrointestinal involvement in systemic sclerosis clinical insights and emerging therapies
topic systemic sclerosis
gastrointestinal tract
digestive system
alimentary tract
url https://cajmhe.com/index.php/journal/article/view/459
work_keys_str_mv AT danabekaryssova gastrointestinalinvolvementinsystemicsclerosisclinicalinsightsandemergingtherapies
AT gulmiramutalipova gastrointestinalinvolvementinsystemicsclerosisclinicalinsightsandemergingtherapies