Gastrointestinal Lupus Complications
Gastrointestinal (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.
- 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
- dry mouth (characteristic of patients with coexisting Sjögren’s syndrome)
- nausea and vomiting
- dysphagia (especially in association with Raynaud’s phenomenon)
- mild nonspecific abdominal pain to severe epigastric pain radiating to the back
- elevated serum amylase level
- abdominal distention
- bulging flanks
- downward protruding
Mesenteric and Intestinal Vasculitis
- cramping or constant abdominal pain
- diffuse direct and rebound abdominal tenderness