SYSTEMIC SCLEROSIS AND THE STOMACH

Systemic sclerosis (SSc) is a complex autoimmune disease characterized by a triad of widespread microvascular obstruction, immunological disorders, and progressive tissue fibrosis. Internal organ involvement is a major cause of morbidity and mortality. The gastrointestinal tract (GI) is the most commonly affected organ, with GI complications occurring in up to 90% of patients. Gastric pathology is primarily manifested by gastroparesis and Gastric Antral Vascular Ectasia (GAVE). Recent studies have identified an early, active, and potentially reversible immunological myopathy and neuropathy driven by muscarinic M3R antibodies and epigenetic dysregulation of microRNAs. This article reviews the cellular pathogenesis, clinical epidemiology, current diagnostic methods, and treatment approaches of GI obstruction, including relamorelin, IVIG, and the 2024 EULAR guidelines.