Self Reported Nutrition Concerns in Scleroderma

Introduction: Gastrointestinal involvement is a nearly universal symptom in systemic sclerosis (SSc, scleroderma). Few studies have investigated nutrition practices in SSc. The purpose of this study was to assess dietary practices, self awareness of nutritional status, and influence of diet on symptoms of gastrointestinal involvement in SSc patients who had received the Scleroderma Foundation "Eating Well with Scleroderma" handout. Methods: Patients were provided the "Eating Well with Scleroderma" handout from the Scleroderma Foundation. At a follow-up visit patients were asked if they had noted any weight loss, if they weigh themselves, if they had identified food that bother their stomach or gut, whether they follow a special diet, and whether they take a PPI and/or probiotic. The UCLA SCTC GIT 2.0 questionnaire, a validated instrument for evaluation of patient-reported outcomes involving the gastrointestinal tract, was administered. Results: All patients reported that their diet influenced their gastrointestinal symptoms. BMI was similar regardless of whether weight was stable, increased or decreased over the past 6 months. Few patients (n=3) lost more than 5 pounds over the past 6 months. Patients who had a weight loss over the past 6 months, more often reported following a special diet, having moderate to severe reflux, and using probiotics than patients with stable or increasing weight. Limiting spicy, greasy and acidic foods was the most commonly reported dietary modification. Conclusion: Patients are universally aware that diet affects gastrointestinal symptoms. This series of patients reported use of probiotics and dietary modifications, particularly those who lost weight and had moderate to severe reflux. Although patients received the "Eating Well with Scleroderma", these results highlight the need to guide nutritional interventions in SSc according to gastrointestinal symptoms.