How Lupus Affects the Digestive System

Learn how lupus affects the parts of the digestive system and how to prevent symptoms.

Lupus is chronic inflammatory condition with an unknown cause that can affect various parts of the body, including the digestive system. The digestive tract involvement may be due to lupus itself, medication side effects or infection. Up to 40% of people with lupus have digestive problems during their lifetime.

  • Mouth

Ulcers (open sores) in the mouth and inflammation of the gums can occur in lupus. Make Peptic Ulcer Disease-causing ulcers (open sores) in the stomach may occur as a side effect of non-steroidal anti-inflammatory medications (NSAIDs). Pain in the abdomen or food-provoked abdominal discomfort, fullness, or nausea are symptoms experienced with peptic ulcer disease. Make sure you visit your dentist regularly.

  • Esophagus

The esophagus is a tube that connects the mouth and stomach. Symptoms such as chest pain, heartburn, regurgitation (backward flow of food), difficulty swallowing and painful swallowing are common symptoms among people who have lupus and esophagus disorders. The disorders include: 

  • Esophageal Motility Disorder  

In this disorder, the muscles in the esophagus fail to contract affecting the movement of food from the esophagus to the stomach. The exact reason why this occurs with lupus is unknown.

  • Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease occurs when the contents of the stomach flow back into the esophagus and cause problematic symptoms.

  • Medication-Induced Esophagitis 

Aspirin and other anti-inflammatory medications can cause inflammation of the esophagus. The size of the pill, quantity of fluids taken with the medication, and patient’s position when taking the medication can affect the risk of irritation. 

  • Infectious Esophagitis 

Due to immunosuppression, people with lupus may have an increased risk of esophageal infection. 

  • Stomach 

Ulcers (open sores) in the mouth and inflammation of the gums can occur in lupus. Make Peptic Ulcer Disease causing ulcers (open sores) in the stomach may occur as a side effect of non-steroidal anti-inflammatory medications (NSAIDs). Pain in the abdomen or food-provoked abdominal discomfort, fullness or nausea are symptoms experienced with peptic ulcer disease. 

Intestines 

Intestinal Pseudo-Obstruction 

Intestinal-pseudo-obstruction is an obstruction of the small or large intestines, in the absence of any growth or tumor that is causing it.

Lupus may cause inflammation of the blood vessels or smooth muscles in the intestines, which may end up causing intestinal pseudo-obstruction. Common symptoms are abdominal pain, bloating and distension.

Protein Losing Enteropathy

This is a rare occurrence in people with lupus, and typically affects young women. There is an excess loss of protein through the gastrointestinal tract. Swelling and severe diarrhea can occur.

  • Liver

Inflammation of the liver from lupus or medications used to treat lupus may occur. Initial symptoms are usually nonspecific and may include loss of appetite and fatigue. People with severe cases may experience jaundice, nausea and vomiting.

  • Pancreas

2-8% of people with lupus may experience inflammation of the pancreas. Abdominal pain that spreads to the back, nausea, vomiting and fever are symptoms associated with inflammation of the pancreas.

  • Abdomen

It is rare, but involvement of the abdominal lining and subsequent buildup of fluids in the abdomen may occur during a lupus flare. People can experience swelling, pain, nausea, vomiting and fever.

Lifestyle changes that may prevent or ease symptoms 

  • Healthy eating – Eat a nutritious, well-balanced diet containing plenty of vegetables, fruits and whole grains.  
  • Be physically active. 
  • Quit smoking – If you drink alcohol, drink in moderation. Alcohol can worsen medication side effects and inflammation of the liver or pancreas. 
  • Medications – To prevent pill esophagitis side effects, take aspirin and other anti-inflammatory medications with lots of fluids while sitting upright. Avoid taking them at bedtime.  
  • Take medications with food or milk – Gastrointestinal side effects of NSAIDs can be reduced if medication is taken with food or milk. 

Manage stress – Use relaxation techniques and get support from family and friends.

It is important to stay on top of your health and treat symptoms early. Know your medication benefits and risks. Discuss with your doctor ways to manage and prevent side effects. Take preventive lifestyle measures to avoid a flare and the involvement of other organ systems.  

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