Systemic sclerosis & Raynaud's
Systemic sclerosis and small bowel involvement: A systematic review of diagnostic approaches and current evidence
Authors' conclusion
In SSc, small bowel involvement is frequent and associated with decreased contractile amplitude and delayed transit time.
Study context
- Population
- Patients with systemic sclerosis (SSc) evaluated for small bowel involvement using objective tests and patient tissue (PubMed and Embase)24 studies
- Outcome
- Small bowel motor abnormalities on manometry (9 studies)
Methodological detailsqualitative synthesis
- Qualitative synthesis
Pooled result
As reported in the abstract
Absent or impaired phase III complexes, median (IQR 22.5%-81%)
50.3%
Reduced phase III migration velocity (IQR 18%-53%)
31.3%
Diminished contraction amplitude, median (IQR 40%-75%)
62.5%
Abnormal postprandial responses, median (IQR 50%-90%)
60.6%
Further pooled results
Correlation between esophageal and small bowel involvement, both assessed by manometry (5 studies)
- No correlation found
Transit studies (breath tests, capsule endoscopy, whole-gut scintigraphy)
- Whole-gut scintigraphy: association with increased mortality, HR
- 4.57 (95% CI 1.58-13.24)
- Variable performance
Histopathology (7 studies)
- Smooth muscle atrophy, enteric neuropathy and vascular fibrosis identified in pathogenesis of small bowel involvement
Original publication
Systemic sclerosis and small bowel involvement: A systematic review of diagnostic approaches and current evidence. Semin Arthritis Rheum. Published 10 April 2026. doi:10.
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