Tackling the GI Symptoms of Scleroderma

Patients with scleroderma often suffer from acid reflux. Among the tests Tsion Abdi and her colleagues perform to measure the condition’s severity is this pH impedance test. Reflux events are indicated at the top of the graph.
Patients with scleroderma often suffer from acid reflux. Among the tests Tsion Abdi and her colleagues perform to measure the condition’s severity is this pH impedance test. Reflux events are indicated at the top of the graph.
Patients with scleroderma often suffer from acid reflux. Among the tests Tsion Abdi and her colleagues perform to measure the condition’s severity is this pH impedance test. Reflux events are indicated at the top of the graph.

When gastroenterologist Tsion Abdi came to Johns Hopkins a year ago to work in the Motility Center after her fellowship at Yale University, she gravitated immediately toward the institution’s Scleroderma Center.

“It’s a busy center and there are so many scleroderma patients who need help managing the challenging GI manifestations of their disease,” she says.

In fact, she adds, gastrointestinal involvement occurs in as many as 90 percent of patients with systemic sclerosis.   GI disease ranges from asymptomatic disease, GERD to severe dysmotility such as esophageal dysfunction, gastroparesis or severe constipation.   Systemic sclerosis is multisystem disease characterized by progressive fibrosis and vascular dysfunction that can wreak havoc on the digestive tract.

The Scleroderma Center is part of the Johns Hopkins University School of Medicine’s Division of Rheumatology and offers patients the multidisciplinary care they need to combat the many facets of this chronic autoimmune disease. Abdi and her colleague Jay Pasricha, director of the Johns Hopkins Center for Neurogastroenterology, represent the GI team in the center.

Abdi says aperistalsis, small intestinal bacterial overgrowth and other gastric problems are a main cause of morbidity and mortality for patients who have systemic scleroderma. Scleroderma is more common in women than men and systemic types are more common in African Americans.

Patients at the Johns Hopkins Motility Center have access to extensive diagnostic services, including, high resolution esophageal manometry, pH testing for acid reflux , and comprehensive GI transit study, where physicians can identify areas in the GI tract with significant dysmotility and target various treatments such as prokinetic medications to improve patient’s symptoms.

 “The science is interesting, but I’m equally drawn to the connection we make with patients who have scleroderma,” says Abdi. “It’s a chronic condition so very likely I’m going to be seeing and treating these people for a long time. My goal is to form a strong doctor patient relationship combined with the most current diagnostics and medications to help improve the quality of life in scleroderma patient with GI disease.  If we’re able to help them live a little better, that feels great.”


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