Scleroderma

Scleroderma is an autoimmune connective tissue disease that occurs in a number of forms, which have slightly different effects. In both the commonest forms the end result is an overproduction of collagen within the effected tissues. This leads to increasing stiffness within the tissues and a feeling of thickening, which can be felt in the skin. A similar process occurs in other tissues. Scleroderma is often classified as either diffuse, when an Scl70 antibody is present, or limited cutaneous (CREST syndrome) characterised by the presence of an anti-centromere antibody.

Whilst scleroderma can affect many organs it may also affect the gut. Commonly patients complain of symptoms of gastro-oesophageal reflux, since the rather stiffer, less motile oesophagus is unable to clear gastric contents from the oesophagus as effectively as a normal oesophagus. In addition patients whose small and large bowel are affected may complain of bloating, constipation and loose stools. This may be directly related to gastro-intestinal dysmotility or be secondary to bacterial overgrowth (potentially correctable) or colonic mal-fermentation which arises as a consequence of the disordered function of the bowel.