Sclerodermatous involvement of the stomach and the small and large bowel.

Peachey, R. D. G.; Creamer, B.; Pierce, J. W.

doi:10.1136/gut.10.4.285

Cited by 51 publications

(5 citation statements)

References 15 publications

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“…Normal subjects showed propagative intestinal patterns during fasting with mean (SD) [1][2][3][4][5] (1 0) phase III complexes occurring every three hours (Fig 1). In contrast, none of the patients with scleroderma with pseudo-obstruction and bacterial overgrowth had any spontaneous duodenal phase III activity (Fig 1).…”

Section: Short Term Effects Of Octreotide On Intestinal Motilitymentioning

confidence: 99%

Octreotide in gastrointestinal motility disorders.

Owyang

1994

Gut

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The effects of octreotide on six normal subjects and five patients with scleroderma were investigated. Changes in intestinal motility and in plasma motilin were examined after a single injection of octreotide. Octreotide stimulated intense intestinal motor activity in normal subjects. Motility patterns in the scleroderma patients were chaotic and non-propagative, but, after octreotide was given, became well coordinated, aborally directed, and nearly as intense as in normal volunteers. Clinical responses and changes in breath hydrogen were also evaluated in the five scleroderma patients who had further treatment with octreotide at a dose of 50 pugtday subcutaneously for three weeks. A reduction in symptoms of abdominal pain, nausea, vomiting, and bloating was seen. Additionally, there was an improvement in bacterial overgrowth as objectively measured by breath hydrogen testing. The effects of octreotide (100 pugtday subcutaneously) on the perception of rectal distension were investigated in a double blind, placebo controlled study in healthy volunteers. Octreotide was shown to reduce the perception of rectal distension without affecting motor pathways or local rectal reflexes. This enhanced tolerance to volume distension seems to result from inhibition of sensory afferent pathways as shown by electroencephalographic studies showing diminished evoked spinal and cortical potentials after octreotide. In irritable bowel syndrome patients with rectal urgency, octreotide reduces rectal pressures and perception after rectal distension to near normal values.

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Section: Short Term Effects Of Octreotide On Intestinal Motilitymentioning

confidence: 99%

Octreotide in gastrointestinal motility disorders.

Owyang

1994

Gut

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“…A two-week course of Rifaximin did not improve her symptoms nor normalized her glucose HBT. Patients with scleroderma may have small bowel dysmotility leading to gut stagnation and bacterial overgrowth [5,6]. Manometry showed intermittent low-amplitude burst of uncoordinated contractive activities and infrequent occurrence of phase 3 migrating motor complexes.…”

Section: Discussionmentioning

confidence: 99%

Rifaximin for Treatment of Small Bowel Bacterial Overgrowth

Owyang

2018

CTGH

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Small intestinal bacterial overgrowth (SIBO) is often secondary to intestinal dysmotility and several other predisposing conditions. Treatment of SIBO typically includes antibiotics and treatment of underlying etiology. Identification and treatment of the underlying modifiable causes is critical for management of refractory and recurrent SIBO. We report here a case of scleroderma with small bowel dysmotility and bacterial overgrowth, on different occasions the patient failed to respond to Rifaximin. We showed that restoring small bowel motility is critical in maintaining the effectiveness of Rifaximin in the treatment of SIBO. Rifaximin resistance may also develop following prolonged use of antibiotics. Rotation of antibiotic regimen is important to prevent drug resistance.

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“…The most characteristic finding in the duodenum, seen in approximately one-third of patients with PSS (21,22), is dilatation of the second and third portions (18,19,(21)(22)(23)(24)(25) as well as hypomotility of these segments (19,23). Distal small bowel involvement, consisting of dilatation, occurs in 10% of patients (21,22,26,27). Involvement of the colon in PSS occurs less frequently than in the esophagus or small bowel (21 ).…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal systemic sclerosis in serologic mixed connective tissue disease

Norman

Fleischmann

1978

Arthritis & Rheumatism

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Mixed connective tissue disease is a clinical entity defined by overlapping features of progressive systemic sclerosis, systemic lupus erythematosus, polymyositis, rheumatoid arthritis, and distinct serologic findings. Esophageal dilatation and dysmotility have been the only gastrointestinal manifestations reported. Three patients with serologic findings of mixed connective tissue disease and extensive gastrointestinal involvement compatible with the changes found in progressive systemic sclerosis are presented. Gastrointestinal manifestations of progressive systemic sclerosis are reviewed and were found to be indistinguishable from the findings in these patients.

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Sclerodermatous involvement of the stomach and the small and large bowel.

Cited by 51 publications

References 15 publications

Octreotide in gastrointestinal motility disorders.

Octreotide in gastrointestinal motility disorders.

Rifaximin for Treatment of Small Bowel Bacterial Overgrowth

Gastrointestinal systemic sclerosis in serologic mixed connective tissue disease

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