Reviewed by Dr Andre Budihardjo, MM and Physician Brandon Yew
The Relationship Between Scleroderma and Gastroesophageal Reflux Disease
Published | 6 min read
Does scleroderma trigger gastroesophageal reflux disease? Learn how it affects the gastrointestinal tract and ways to manage the disease holistically.
Here’s a fun fact: The term scleroderma comes from the Greek words skleros and derma, which translates to hard and skin, respectively. It causes smooth muscle fibrosis – a development of fibrous connective tissues in response to injury or damage – within the smooth muscle layers, hardening skin.
Even more interesting, scleroderma can bring about gastroesophageal reflux disease (GERD), which presents as heartburn, difficulty swallowing or a lump in the throat. Raynaud’s phenomenon, where fingers and toes turn blue, white or red, is common too. This is due to the contraction of the small blood vessels in the fingers and toes in response to the cold or emotional distress.
Read on to understand the relationship between both diseases and how early intervention can help heal the former permanently.
Understanding How Scleroderma and Gastroesophageal Reflux Disease Co-exists
Oesophageal dysfunction commonly affects people with scleroderma. A ring of muscle called the lower oesophageal sphincter sits at the junction between the stomach and oesophagus. When a person isn’t swallowing, the sphincter will contract, preventing reflux and pushing gastric contents back into the oesophagus. However, this function is impaired in people with scleroderma, predisposing them to gastroesophageal reflux disease (GERD) symptoms.
One other function that is impaired in people with scleroderma is the rate of stomach emptying. People with scleroderma will have delayed emptying of the stomach (gastroparesis), another predisposing factor for GERD.
The Five Elements theory
Traditional Chinese Medicine (TCM) likens the onset of scleroderma and gastroesophageal reflux disease to the bond between a mother and son, according to Real Health Medical’s Senior Physician Brandon Yew.
Based on the Five Element theory, the Lungs, which govern the skin, are represented by the Metal element (the mother). The Spleen relates to the digestive system and represents the Earth element (the son).
“There are two scenarios involving this family of elements. Firstly, a person with scleroderma often presents with Lung syndrome. The Lungs’ (Metal element, mother) dysfunctions are passed to the Spleen (Earth, son) over time, provoking onset gastrointestinal disorders. This includes gastroesophageal reflux disease (GERD).
“Secondly, a person with GERD is perceived to have Spleen syndrome. If not promptly resolved, Lung health too, will become poor. This will trigger several skin conditions including scleroderma,” explains Physician Yew.
A Multi-factor Treatment Plan for Scleroderma and Gastroesophageal Reflux Disease
Before delving into the available treatment options for scleroderma, remember that lifestyle modification can help prevent the disease’s onset. These include:
- Exercising regularly
- Getting sufficient, restful sleep
- Maintaining work-life balance
- Managing positive emotion control
- Consuming a healthy and balanced diet
- Limiting your consumption of alcoholic beverages and quitting smoking
Treating Gastroesophageal Reflux Disease with herbal formulas
Separately, herbal formulas and acupuncture can make a person less susceptible to gastroesophageal reflux disease by strengthening the Spleen and Stomach and dispelling pathogens like Cold, Fire, Dampness, phlegm, Blood Stagnation, and Qi (vital life force) Stagnation.
Examples of these are:
- Li Zhong Wan (理中丸)
- Xie Huang San (泻黄散)
- Yi Wei Tang (益胃汤)
- Zuo Jin Wan (左金丸)
- Wu Zhu Yu Tang (吴茱萸汤)
- Ban Xia Xie Xin Tang (半夏泻心汤)
- Ge Xia Zhu Yu Tang (膈下逐瘀汤)
- Zhi Shi Dao Zhi Wan (枳实导滞丸)
- Zhi Shi Xiao Pi Wan (枳实消痞丸)
- Xiang Sha Liu Jun Zi Tang (香砂六君子汤)
Prescription medications for symptomatic relief and overall well-being
Once a healthcare provider diagnoses a person with scleroderma, they may recommend medications to relieve symptoms, treat complications and maintain the functionality of several body parts.
A person’s prescription may include one of the following:
- Lotions and moisturisers to calm skin itchiness
- Corticosteroids or non-inflammatory, anti-steroidal pain relief medications
- Medications that improve blood flow and regulate blood pressure
- Immune system suppressing medications to slow skin hardening and reduce organ damage
Herbal formulas to treat scleroderma during the early stages
It’s possible to cure scleroderma permanently if a person seeks treatment promptly. Otherwise, TCM remedies may only be beneficial for alleviating disease symptoms. Herbal formulas can address scleroderma-associated syndromes, which are characterised by multiple pathological combinations and unique body constitutions of specific imbalances.
The herbal formulas that a licensed TCM practitioner will likely propose are:
- Yin Qiao San (银翘散)
- Bu Yang Huan Wu Tang (补阳还五汤)
- Chai Ge Jie Ji Tang (柴葛解肌汤)
- Dang Gui Si Ni Tang (当归四逆汤)
- Jing Fang Bai Du San (荆防败毒散)
- Shen Tong Zhu Yu Tang (身痛逐瘀汤)
- Gui Zhi Shao Yao Zhi Mu Tang (桂枝芍药知母汤)
- Huang Qi Gui Zhi Wu Wu Tang (黄芪桂枝五物汤)
- Ma Huang Xi Xin Fu Zi Tang (麻黄细辛附子汤)
These formulas effectively dispel pathogens, restore the body’s vital elements – qi, blood, yin (passive energy) and yang (active energy) – and strengthen the Spleen and Lungs.
Stimulating acupressure points to remedy the underlying syndromes of scleroderma and GERD
Acupressure points can also be activated to relieve scleroderma and GERD symptoms. These are:
- Tai xi (KI3, 太谿)
- He gu (LI4, 合谷)
- Tai chong (LR3, 公孙)
- Nei guan (PC6, 內关)
- Guan yuan (RN4, 关元)
- Qi hai (RN6, 气海)
- San yin jiao (SP6, 三阴交)
- Zu san li (ST36, 足三里)
If you notice your skin hardening, see a healthcare provider immediately. Early testing will increase your chances of beating scleroderma and stop gastroesophageal reflux disease from developing. Physician Yew also cautions, “It’s strongly advised that you don’t self-medicate using herbal formulas or ingredients without consulting a licensed TCM practitioner. Also, do note that acupressure only provides mild symptomatic relief and is incapable of tackling the root pathological reasons behind scleroderma.”
- Medscape. 2022. Scleroderma. [online] [Accessed 24 June 2022]
- The American Journal of Gastroenterology. 2015. Gastroesophageal Reflux Disease in Scleroderma: Effects on Sleep Quality, Fatigue, and Quality of Life. [online] [Accessed 24 June 2022]
- Johns Hopkins Medicine. Scleroderma Treatment. [online] [Accessed 24 June 2022]
- UCLA Health. Scleroderma. [online] [Accessed 24 June 2022]
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