Busra Firlatan YAZGAN, Gozde Sevgi Kart BAYRAM, Erdinc UNALDI, Mustafa EKICI, Gül Sandal UZUN, Alper SARI, Levent KILIC, Ali AKDOGAN
Rheumatology Quarterly - 2026;4(3):183-190
Objective: Severe gastrointestinal (GI) involvement in systemic sclerosis (SSc) is often recognized at advanced stages. This study aimed to evaluate the frequency of endoscopic procedures in SSc, characterize GI involvement, and determine whether endoscopic evaluations are associated with symptom severity. Methods: A total of 104 consecutive SSc patients were enrolled. Demographic and clinical data, along with GI symptoms, were recorded. Available upper (E/S) and lower (C/S) GI endoscopy findings were documented. Malnutrition was assessed using Malnutrition Universal Screening Tool (MUST) and European Society for Clinical Nutrition and Metabolism (ESPEN) criteria, and GI severity was evaluated with the University of California Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 (UCLA SCTC GIT 2.0) score. Results: Among 104 patients (92.3% female; mean age 52 +/- 13 years), 66.3% underwent E/S and 42.3% underwent C/S during the disease course. Moderate-to-severe GI symptoms were present in 30.8% of patients. Recent endoscopy (within 2 years) was associated with greater symptom severity, with 50% of patients undergoing E/S and C/S classified as moderate-to-severe, compared to 23% and 25% without recent procedures (P = .007 and P = .020, respectively). Endoscopy rates did not differ by malnutrition status. Conclusion: Endoscopic procedures are frequently performed in SSc. Recent procedures are significantly associated with moderate-to-severe GI symptom burden. The UCLA SCTC GIT 2.0 appears to reflect real-world clinical symptom severity and may serve as a useful tool to follow-up GI symptom severity.
