Scleroderma, Ehlers-Danlos syndrome and other rheumatological conditions and the gut

Patients with multiple systemic rheumatologic conditions suffer from an array of gastrointestinal symptoms. These gastrointestinal symptoms are generally related to organ involvement in disorders such as scleroderma, Sjogren’s, systemic lupus erythematosus, rheumatoid arthritis, and inflammatory myopathies. The high prevalence of symptoms of functional gastrointestinal disorders and Ehlers-Danlos syndrome, particularly Type III EDS or hypermobile EDS, has drawn increased attention and is being reviewed. Patients with significant GI symptoms have a worse quality of life than those without these symptoms. This chapter reviews the pathophysiology underlying the gastrointestinal dysfunction in these rheumatological conditions. Their common clinical presentations and available diagnostic studies based on symptom presentation can support the finding of gastrointestinal organ involvement. In general, these studies are indicated if the outcome will impact the therapeutic plan for any individual patient. There are limited treatment options and the treatment approaches center around medications and proper nutrition. Caring for these patients often requires a multidisciplinary approach with primary care physicians, rheumatologists, gastroenterologists, and dieticians.