Background Gastrointestinal tract (GIT) involvement in systemic sclerosis (SSc) is common, occurring in 50–90% of the patients (1). However, there is limited knowledge of self reported GIT symptoms affecting patients in daily life.
Objectives To describe frequency and severity of self reported gastrointestinal symptoms in a large SSc cohort and evaluate possible correlations between special clinical characteristics and GIT-symptoms.
Methods Patients from the The Norwegian Systemic Connective Tissue Disease and Vasculitis Registry (NOSVAR) who fulfilled the 2013 ACR/EULAR SSc criteria were included (N=245)). The patients completed the UCLA SCTC GIT 2.0 questionnaire which comprises seven clinical symptoms; Reflux, distention/bloating, diarrhea, fecal soilage, social functioning, emotional well-being and constipation. All variables are scored from better to worse in health related quality of life (HRQL) with a mean total score of 2.8. In addition we used the visual analogue scale on intestinal problems (VAS-GIT) of the Scleroderma Health Assessment Questionnaire (SHAQ) with a maximum score of 3. Disease duration was defined as time from diagnosis to the completion of the questionnaires. Possible correlations were tested by Spearman's correlation coefficient.
Results Patient characteristics and frequencies of the different GIT symptoms are presented in Table 1. Distention bloating, reflux and diarrhea were the most frequent symptoms reported (80%, 69% and 61%, respectively. The least reported symptom was fecal soilage (16%) (Figure 1). Mean (SD) total GIT score was 0.42 (0.41), indicating mild symptoms. The seven subscales ranged from mean (SD) 0.22 (0.55) for fecal soilage to mean (SD) 0.95 (0.50) for distention/bloating. Mean (SD) VAS-GIT score was 0.33 (0.37) and correlated strongly with the mean total UCLA-GIT score (0.667, p<0.001). Female sex and disease duration correlated weakly with mean total UCLA-GIT score (r=-.234, r=199, respectively), as did positive anticentromere-antibody (r=.229).No correlation was found between mean total UCLA-GIT score and subset of SSc, interstitial lung disease, pulmonary hypertension, digital ulcers, Rodnan skin score or Raynaud.
Conclusions This study describes a high frequency of self-reported gastrointestinal symptoms in systemic sclerosis patients classified as mild to moderate symtoms. Positive anticentromere-antibody, disease duration and female sex had a minor impact on mean total UCLA-GIT score. The correlation between mean total UCLA-GIT score and the VAS-GIT score of the SHAQ was highly significant indicating a good conformity between the tests.
Forbes A, Marie I: Gastrointestinal complications: the most frequent internal complications of systemic sclerosis. Rheumatology (Oxford) 2009;48 Suppl 3:36–9.
Disclosure of Interest None declared