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Gastrointestinal Lupus Complications


gastrointestinal systemGastrointestinal (GI) problems are common and range from vague complaints of anorexia to life-threatening bowel perforation secondary to mesenteric arteritis. Anorexia, nausea, vomiting, and diarrhea may be related to the use of salicylates, NSAIDs, antimalarials, corticosteroids, and cytotoxic drugs.

Potential Problems:

  • alteration in GI function related to drug therapy or disease process
  • nutritional deficiencies

Lups patients who present with acute abdominal pain, esophageal dysmotility, and tenderness need immediate, aggressive, and comprehensive evaluation to rule out an intra-abdominal crisis. Ascites, an abnormal accumulation of fluid in the peritoneal cavity, is rare. Pancreatitis is a serious complication occurring in approximately 5 percent of Lupus patients and is usually secondary to vasculitis.

Mesenteric or intestinal vasculitis is a life-threatening condition that may have complications of obstruction, perforation, or infarction. It is rare. Abnormal liver enzyme levels are also found in about one-third of Lupus patients, and can be from lupus, infection, or medication.

Summary of Potential GI Lupus Complications

General Symptoms

  • dry mouth (characteristic of patients with coexisting Sjögren’s syndrome)
  • anorexia
  • nausea and vomiting
  • diarrhea
  • dysphagia (especially in association with Raynaud’s phenomenon)

Pancreatitis

  • mild nonspecific abdominal pain to severe epigastric pain radiating to the back
  • nausea
  • vomiting
  • elevated serum amylase level
  • dehydration

Ascites

  • abdominal distention
  • bulging flanks
  • downward protruding
  • umbilicus

Mesenteric and Intestinal Vasculitis

    • cramping or constant abdominal pain
    • vomiting
    • fever
    • diffuse direct and rebound abdominal tenderness

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