How can I treat gastrointestinal problems caused by scleroderma?

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Heather McDougall, MD
Gastroenterology
Gastrointestinal involvement in scleroderma consists of a variety of symptoms that include nausea, vomiting, difficulty swallowing, constipation, diarrhea, gastroesophageal reflux disease, problems with digestion, gastroparesis, and watermelon stomach. The most common issues are severe reflux, malabsorption due to small bowel bacterial overgrowth, and severe constipation leading to impaction and sometimes intestinal obstruction. Treatment usually includes a proton pump inhibitor (Prilosec or Nexium are typical) to treat the reflux. Small bowel bacterial overgrowth is usually treated with antibiotics and a probiotic. Constipation can be relieved by increasing water intake, regular exercise, increasing dietary fiber, and taking stool softeners or Miralax regularly.
Dr. Michael Roizen, MD
Internal Medicine

Depending on which GI symptoms you have, any or all of the following tips will help.

• Eat smaller meals more frequently (this is good for you anyway since it prevents a blood-sugar roller coaster ride).

• Avoid taking a nap or lying down immediately after eating. Try to sit or stand for at least 1 hour (2 to 3 is better).

• Avoid late-night meals no matter how tempting they are.

• Avoid flamers (foods or drinks that aggravate your heartburn and reflux). Most often they include spicy and fatty foods and alcoholic or caffeinated beverages.

• Return to your toddler days and eat moist, soft foods. Make sure you chew them well, too.

• Take medications for diarrhea, constipation, heartburn, and reflux.

• Put a couple of blocks or bricks under the front legs of your bed to keep it elevated. This keeps acid from flowing up your esophagus while you sleep.

 


Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
A combination of dietary changes and medication is typically used to treat the gastrointestinal problems of scleroderma. Softer foods, eaten while upright, can aid in the digestive process, while acid reflux medications can help the symptoms of GERD reported by many.


In addition to skin changes, gastrointestinal (GI) problems are often brought on by scleroderma. Symptoms may include heartburn, diarrhea, constipation, gas, acid reflux, and eating difficulties. People with scleroderma may also have problems absorbing nutrients from food. To help alleviate these symptoms, there are some lifestyle changes you can make. Eat smaller, more-frequent meals and avoid late-night meals and spicy or greasy foods. Avoid alcohol and caffeine, which can further irritate your digestive system. It's also important to sit or stand for a few hours after eating, and when you do lie down, keep your head elevated above your torso to cut down on the chances of acid reflux. Antacids, which help slow the production stomach acid, may also be helpful.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.