A clinical case of gastrointestinal bleeding in a patient with systemic sclerosis

Systemic sclerosis (SS) is a disease with diverse clinical manifestations, with common damage of the gastrointestinal tract (GIT). The traditional description of GIT disorders includes the development of strictures of the lower third of the esophagus due to its scarring with recurrent ulcerative lesions, gastric bleeding due to telangiectasis of the gastric mucosa or ulcerative defects due to ischemia and drug therapy. The development of GIT bleeding is a life-threatening complication of SS. The causes of gastrointestinal bleeding in this category of patients may be both abnormalities of the gastrointestinal mucosa associated with the manifestations of the disease, as well as the effect of basic drug therapy, as well as the presence and treatment of concomitant diseases. In this aspect, early diagnosis of mucosal changes from the digestive tract is a key point in choosing methods for patients monitoring to determine the best tactics of drug therapy, taking into account the benefit/risk ratio while achieving symptom control with improved prognosis. Doctors treating patients with SS should pay attention to the increased risk of gastrointestinal bleeding, especially among patients with comorbid vascular pathology (diabetes mellitus, hypertension, atrial fibrillation), requiring additional use of vasodilators, anticoagulants. Consideration should be given to the endoscopic monitoring of GIT complications among patients with SS, especially those with additional risk factors for damage to the upper GIT, which will useful an appropriate assessment of the risk of bleeding and may ensure timely preventive measures.