Factors associated with development of gastrointestinal problems in patients with scleroderma: a systematic review. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Hong, Brian; Giang, Raymond; Mbuagbaw, Lawrence; Larche, Maggie; Thabane, Lehana
• Is Part Of: Systematic reviews. Volume 4:Issue 1(2015)
• Page Start: 1
• Page End: 8
• Publication Date: 2015-12
• Subjects: Systematic review -- Scleroderma -- Gastrointestinal -- Risk factors; Systematic reviews (Medical research) -- Periodicals; 616.0072
• DOI: 10.1186/s13643-015-0176-2
• Languages: English
• ISSNs: 2046-4053

Abstract

Abstract Background Up to 90 % of people with scleroderma have gastrointestinal (GI) problems such as constipation, bloating, diarrhea, and malabsorption. These problems significantly impair quality of life. Our objective was to determine the risk factors for gastrointestinal issues in people with scleroderma. Methods We conducted a systematic review of observational studies that report GI problems in patients with scleroderma along with the associated risk factors. We were interested in any GI problem and any risk factor as long as the study included patients diagnosed with scleroderma according to the 1980 or 2013 American College of Rheumatology guideline. We searched the following databases: CINAHL, EMBASE, LILACS, MEDLINE, and Web of Science for relevant articles from June 1884 to May 2014. Two authors independently screened citations and full text articles and extracted data. Discrepancies were resolved by consensus or by consulting a third author. Methodological quality of included studies was assessed using the Newcastle-Ottawa Scale. Results After removing duplicates, 645 unique citations were identified. A total of three studies, three cross-sectional (n = 64, n = 42, n = 606), were included in this systematic review. Collectively, these three studies exploredHelicobacter pylori and smoking status as risk factors. We found conflicting evidence on the role ofH. pylori with two studies showing opposite yet statistically significant results. One moderate quality study showed smoking as a risk factor. Key limitations include the small sample sizes of two studies and poor study designs to draw causal links. Conclusions There is insufficient evidence to describe the risk factors for GI problems in patients with scleroderma. Longitudinal observational studies are warranted in patients with scleroderma. Systematic review registration PROSPEROCRD42014010707