Gastrointestinal Involvement in Children and Adolescents with Rheumatic Diseases

Pediatric rheumatic diseases are often associated with gastrointestinal symptoms. Abdominal pain is the most frequently reported complaint. In this review, we discuss the gastrointestinal manifestations of chronic rheumatic syndromes: motility disorders of collagenosis, mixed connective tissue disease and Sjögren's syndrome associated with the risk of esophagitis due to gastro-esophageal reflux. Furthermore, we summarize data about non-steroidal antiinflammatory drug-induced gastroduodenal lesions in childhood and adolescence. The relevance of co-medication with steroids for the pathogenesis of these lesions is controversial. Further prospective studies are necessary to examine which sensitivities and specifics are raised by invasive and non-invasive procedures such as endoscopy, testing of intestinal and gastric permeability, fecal 1-antitrypsin excretion, and fecal occult blood testing to indicate gastrointestinal lesions in pediatric rheumatic diseases.