Treating Gastrointestinal and Lung Problems in People With Scleroderma
Systemic sclerosis can affect any part of the digestive system. As a result, you may experience problems such as heartburn, difficulty swallowing, early satiety (the feeling of being full after you've barely started eating), or intestinal complaints such as diarrhea, constipation, and gas. In cases where the intestines are damaged, your body may have difficulty absorbing nutrients from food.
Although gastrointestinal problems are diverse, the following suggestions may help:
- Eat small, frequent meals.
- Raise the head of your bed with blocks, and stand or sit for at least an hour (preferably two or three) after eating to keep stomach contents from backing up into the esophagus.
- Avoid late-night meals, spicy or fatty foods, and alcohol and caffeine, which can aggravate gastrointestinal distress.
- Chew foods well and eat moist, soft foods. If you have difficulty swallowing, or if your body doesn't absorb nutrients properly, your doctor may prescribe a special diet.
- Ask your doctor about prescription medications for problems such as diarrhea, constipation, and heartburn. Some drugs called proton-pump inhibitors are highly effective against heartburn. Oral antibiotics may stop bacterial overgrowth in the bowel that can be a cause of diarrhea in some people with systemic sclerosis.
About 10 to 15 percent of people with systemic sclerosis develop severe lung disease, which comes in two forms:
- Pulmonary fibrosis (hardening or scarring of lung tissue because of excess collagen)
- Pulmonary hypertension (high blood pressure in the artery that carries blood from the heart to the lungs).
Treatment is different for each of these conditions. Pulmonary fibrosis may be treated with drugs that suppress the immune system, such as cyclophosphamide (Cytoxan®) or azathioprine (Imuran®), along with low doses of corticosteroids. Pulmonary hypertension may be treated with drugs that dilate the blood vessels, such as prostacyclin or iloprost.
To minimize lung complications, work closely with your medical team and do the following:
- Watch for signs of lung disease, including fatigue, shortness of breath or difficulty breathing, and swollen feet. Report these symptoms to your doctor.
- Have your lungs closely checked, using standard lung-function tests, during the early stages of skin thickening. These tests, which can find problems at the earliest and most treatable stages, are needed because lung damage can occur even before you notice any symptoms.
- Get regular flu and pneumonia vaccines. Contracting either illness could be dangerous for a person with lung disease.