AB0745 Symptoms of gastrointestinal disorders in systemic sclerosis patients with different disease subtypes and antibodies

Abstract

BackgroundGastrointestinal tract is the second most commonly affected organ system in approximately 90% of patients with systemic sclerosis (SSc) and has a negative impact on health-related quality of life (1,2).ObjectivesThis study aims to analyze frequency and severity of gastrointestinal symptoms, their impact on social functioning and emotional wellbeing and compare results among patients with limited cutaneous (lcSSc) and diffuse cutaneous systemic sclerosis (dcSSc), as well as in patients with anti-centromere antibodies (ACA) and anti-topoisomerase I antibodies (ATA).Methods42 patients with SSc were included in this study, 31 of them with lcSSc and 11 patients with dcSSc. ACA were detected in 26, and ATA in 16 patients. The UCLA-SCTC-GIT 2.0 self-assessment questionnaire (3,4) was used to assess presence and severity of gastrointestinal symptoms in our patients. It consists of seven scales: reflux, distension/bloating, diarrhea, fecal soilage, constipation, social functioning and emotional wellbeing.ResultsThere was no difference in percentage of patients with lcSSc and dcSSc who used proton pump inhibitors (27.27%: 32.25%), as well as in patients with ACA and ATA (34.61%: 25%). Symptoms of gastroesophageal reflux (lcSSc: dcSSc = 64.5%: 81.8%), distension/bloating (lcSS: dcSSc = 61.3%: 81.8%), constipation (lcSSc: dcSSc = 45.2%: 45.5%) and fecal soilage (lcSSc: dcSSc = 6.4%: 18.2%) were found equally frequent (p>0.05) in patients with lcSSc and dcSSc. However, symptoms of diarrhea were found significantly more frequent in patients with dcSSc (lcSSc: dcSSc = 16.1%: 45.5%, p=0.04). The mean index value for diarrhea was significantly higher in patients with dcSSc (dcSSc: lcSSc = 0.45: 0.11, p=0.02), indicating more severe symptoms in diffuse form of disease. We did not notice a significant difference in frequency or severity of gastrointestinal symptoms in patients with ACA and ATA. Mean index values of social functioning and emotional wellbeing did not differ significantly in patients with lcSSc and dcSSc, as well as in patients with ACA and ATA.ConclusionUnlike other gastrointestinal manifestations, diarrhea is significantly more common and more severe in patients with dcSSc. No significant difference in frequency and severity of gastrointestinal symptoms was found in patients with ACA and ATA. Impact of gastrointestinal tract symptoms on social functioning and emotional wellbeing was similar in both forms of disease and antibodies.References[1]Kedia S, Chhaparia A, et al. Gastrointestinal involvement in systemic sclerosis. Indian J Rheumatol 2017; 12, Suppl S1: 156-66.[2]Hudson M, Thombs BD, et al. Health-related quality of life in systemic sclerosis: a systematic review. Arthritis Rheum. 2009;61(8):1112-20.[3]Khanna D, Hays RD, et al. Reliability and validity of the University of California, Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument. Arthritis Rheum. 2009;61(9):1257-63.[4]Zekovic A, Damjanov N. Validation of Serbian version of UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument in 104 patients with systemic sclerosis. Rheumatol. 2017;37(5):735–41.Disclosure of InterestsNone declared