What kind of small intestine (bowel) problems occur in scleroderma?

Module: Dysphagia and the Digestive Tract

Janet L. Poole, PhD, OTR/L, and Cindy Mendelson, PhD, RN, and Dinesh Khanna, MD, MS

Food moves from the stomach to the small intestines (small bowel), where vitamins and other nutrients are separated from waste. People who have problems with their small intestines experience stomach enlargement or bloating, nausea, and vomiting. If too much bacteria is present in the small intestines (“bacteria overgrowth syndrome”), people may have diarrhea, weight loss, and bad-smelling stools. False obstruction of the bowels (pseudo-obstruction) means the bowels are not really blocked but have stopped working. People may experience belly pain, a large belly, and vomiting, and cannot pass gas. People with pseudo-obstruction may have to go to the hospital to rest the small bowel.

What tests are used to diagnose problems in the small intestine?

Breath test

A breath test can be used to see whether there is too much bacteria in the small intestine. When there is too much bacteria, it breaks down sugar, and the byproduct, hydrogen, can be found in the breath.

CT scans or x-rays

These tests will help the doctor decide whether something is actually blocking the small intestine or whether the symptoms are caused by just weakness.

Medications and medical procedures used to treat problems with the small intestine


Antibiotics, such as rifaximin and neomycin, may be prescribed by your doctor to reduce bacteria overgrowth. The treatment may need to be repeated, or other types of antibiotics may need to be prescribed, because sometimes the bacteria may become resistant to the antibiotic, and the antibiotic will stop working.

Promotility and probiotic products

Promotility products may be prescribed to stimulate the intestines to start working again.

Yogurt and probiotics (Florastor®, Culturelle®, Align®) may be used to help get rid of symptoms and to bring back and keep the right balance of bacteria in the intestines.