Recasens M A Asunción, Puig Celia, Ortiz-Santamaria Vera
Unidad de Endocrinología, Hospital General de Granollers, España.
Reumatol Clin. 2012 May-Jun;8(3):135-40. doi: 10.1016/j.reuma.2011.09.006. Epub 2011 Dec 24.
Systemic sclerosis is a connective tissue disease characterized by inflammation and fibrosis of multiple organs (skin, gastrointestinal tract, lung, kidney and heart). After the skin, the organ most affected with a frequency of 75 to 90%, the gastrointestinal tract is more often involved. Gastrointestinal tract involvement is manifested by the appearance of oropharyngeal dysphagia, esophageal dysphagia, gastroesophageal reflux, gastroparesis, pseudo-obstruction, bacterial overgrowth and intestinal malabsorption, constipation, diarrhea and/or fecal incontinence. These effects influence food intake and intestinal absorption leading to the gradual emergence of nutritional deficiencies. About 30% of patients with systemic sclerosis are at risk of malnutrition. In 5-10%, gastrointestinal disorders are the leading cause of death. Therapeutic strategies currently available are limited and aimed at reducing clinical symptoms. The multidisciplinary management of these patients, including nutritional intervention, helps improve gastrointestinal symptoms, and avoid malnutrition, morbidity and improve quality of life.
系统性硬化症是一种结缔组织疾病,其特征为多个器官(皮肤、胃肠道、肺、肾和心脏)发生炎症和纤维化。在皮肤之后,胃肠道是受影响最频繁的器官,发生率为75%至90%,更常受累。胃肠道受累表现为口咽吞咽困难、食管吞咽困难、胃食管反流、胃轻瘫、假性肠梗阻、细菌过度生长和肠道吸收不良、便秘、腹泻和/或大便失禁。这些影响会影响食物摄入和肠道吸收,导致营养缺乏逐渐出现。约30%的系统性硬化症患者存在营养不良风险。在5%至10%的患者中,胃肠道疾病是主要死因。目前可用的治疗策略有限,旨在减轻临床症状。对这些患者进行多学科管理,包括营养干预,有助于改善胃肠道症状,避免营养不良、发病,并提高生活质量。