Division of Rheumatology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Opin Rheumatol. 2022 Nov 1;34(6):328-336. doi: 10.1097/BOR.0000000000000899. Epub 2022 Aug 19.
The majority of patients with systemic sclerosis (SSc) will experience involvement of their gastrointestinal over the course of their disease. Despite the high prevalence of gastrointestinal involvement in SSc, the strategies pertaining to the assessment and treatment for this clinical dimension of SSc have historically been limited. However, the present review highlights recent research contributions that enhance our understanding of SSc-GI patient subsets and provides updates on pathogenic mechanisms of disease, assessment and symptom-directed management.
In the past few years, several studies have identified risk factors for more severe gastrointestinal disease in SSc and have provided insight to optimize diagnosis and management of SSc-GI symptoms. This article also provides a review of currently available investigations and therapies for individual SSc-GI disease manifestations and reflects on actively evolving areas of research, including our understanding the role of the gut microbiome in SSc.
Here, we provide important updates pertaining to the risk stratification, assessment, diagnosis and management of SSc patients with gastrointestinal symptoms. These findings provide opportunities to enhance patient care and highlight exciting opportunities for future research.
大多数系统性硬化症(SSc)患者在疾病过程中会出现胃肠道受累。尽管 SSc 患者胃肠道受累的患病率很高,但针对这一 SSc 临床方面的评估和治疗策略在历史上一直受到限制。然而,本综述强调了最近的研究进展,这些进展增进了我们对 SSc-GI 患者亚群的理解,并提供了疾病发病机制、评估和症状导向治疗的最新信息。
在过去的几年中,有几项研究确定了 SSc 中更严重胃肠道疾病的危险因素,并深入了解了优化 SSc-GI 症状的诊断和管理。本文还综述了目前针对个别 SSc-GI 疾病表现的可用研究和治疗方法,并思考了正在积极发展的研究领域,包括我们对肠道微生物组在 SSc 中作用的理解。
本文提供了有关胃肠道症状 SSc 患者的风险分层、评估、诊断和管理的重要更新。这些发现为改善患者护理提供了机会,并突出了未来研究的令人兴奋的机会。