DR. CORA LIM-MEDICAL INSIDER

Systemic Sclerosis

(SCLERODERMA)

Last week, we started discussing Systemic Sclerosis otherwise known as scleroderma. I said, the word means hard skin (sclera = hard, derma = skin). 

I presented to you the symptoms of Systemic Sclerosis, including the person’s sensitivity to cold and the changes of the skin.

Digestive Problems:

Today, we will know the digestive problems of the person who has Systemic Sclerosis and these digestive problems include the following: a) Difficulty swallowing food due to tightening of food pipe; b) Heart burn/acidity; c) Diarrhea/constipation

Joint Problems:

The person will also have joint problems presented in the form of pain stiffness and swelling of joints.

Complications:

Moreover, complications may develop in a small number of patients as shown in the following: 1) Scarring (fibrosis) of their lungs, causing shortness of breath, a dry cough; 2) Narrowing of the blood vessels of their lungs; 3) Kidney problems resulting in high blood pressure

It is really advised that a regular follow up with a rheumatologist is important because the earlier the complication is recognized and treated, the better the outcome.

Which tests are done?

The following tests may be done on the patient:

  • Blood tests, such as ANA test, anti centromere or anti Scl-70 antibodies
  • Chest X-rays and computerized tomography (CT) scans 
  • Breathing tests
  • A heart scan (echocardiogram or ECG) Stomach tests, for example an endoscopy
  • A skin biopsy, if needed

SELF HELP MEASURES

Self help measures may also be advisable such as the following: a) Eat six small meals a day instead of three larger ones Eat slowly, chew thoroughly; b) Drink plenty of water with meals; c)Taking your largest meal in the middle of the day can help you to avoid heartburn; d) Don’t eat too much in the evening to make sure you have time for digestion before you go to bed; e) Raise the head of your bed a few inches to stop acid coming back up from your stomach; f) Keep your hands and chest warm, use mittens and sweater; g) Regular exercise to prevent contractures

TREATMENT OPTIONS

The treatment options which the patient may take usually include managing all the four salient symptoms with the use of pain killers, NSAIDS, stomach protection agents, skin moisturizing agents, measures to keep chest and peripheries warm. Specific treatment may also include: Steroids, Immunosuppressive agent, Blood pressure and cholesterol lowering drugs if needed