Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition (154 page)

Sclerodactyly:
This is the thickening that occurs on fingers and toes. It can look shiny and can limit your flexibility and ability to use fingers and toes.

Telangiectasias:
These are tiny red areas that most often occur on your face and hands, inside your mouth, and inside of your lips. If you press on them, they turn white.

Medical treatment of scleroderma consists of dealing with symptoms and medical issues as they arise. Proton-pump inhibitors are used for GERD. Small intestinal bacterial overgrowth (SIBO) is treated with antibiotics. If your lungs or kidneys are affected, those are treated as well. If blood pressure is high, that is also treated.

Integrative treatment consists of looking for underlying triggers and modulating inflammation, use of elimination diets and celiac testing, stress management, looking for and treating infections, looking for allergies and sensitivities to food and environmental chemicals, and anything else that may be of benefit in alleviating symptoms and slowing down the course of the disease.

In one study, use of vitamin B
₆
and a Chinese medication called Xuefu Zhuyu Decoction were used in 33 people with localized scleroderma. Reductions in inflammation of interleukin-6 (IL-6) and TNF-alpha were similar in both groups. It is believed that the B
₆
and herbal combination activated blood circulation.

GI issues are present in 50 to 90 percent of people with scleroderma. There can be issues in any one of the DIGIN areas, so look at all of them carefully. The most common manifestations of scleroderma are in the esophagus with reflux and difficulty swallowing. If left untreated this can lead to Barrett’s esophagus. There can also be constipation or diarrhea, SIBO, and food sensitivities. SIBO occurs 17 to 58 percent of the time in people who have scleroderma. When treated, symptoms improve.

Delayed gastric emptying is found in 10 to 75 percent of people with systemic scleroderma. This correlates well with symptoms of early satiety, bloating, and vomiting.

H. pylori can be an issue in people who have scleroderma and GERD. Kanako Yamaguchi and colleagues tested 64 patients with scleroderma who had not been treated for GI imbalances. Thirty-seven (57.8 percent) tested positive for H. pylori. Significantly more people without GERD had high H. pylori levels.

There is a high overlap of celiac disease in people with scleroderma. Eduardo Rosato and colleagues report that of 50 people studied, 5 had elevated tissue transglutaminase levels. When biopsied, four of the five had celiac disease, for an incidence of 8 percent. Remember that celiac disease is diagnosed only when there is serious erosion of the villi and microvilli. This study did not look at simple gluten intolerance.

Free radical damage underlies the pathology of scleroderma. There are elevated levels of Th-2 cytokines (IL-6) in the early stages of scleroderma that lead to the thickening of tissues. Antioxidants are beneficial in people with scleroderma. Raynaud’s causes a surge of free radicals that need to be quenched. Studies have shown that blood levels of vitamin C, vitamin E, selenium, and carotenoids are all lower in people with scleroderma, despite normal levels in their diets. G. Fiori and colleagues report that vitamin E used topically increases healing and reduces pain. It’s also speculated that taurine can be used as an antioxidant. Supplementation with antioxidant nutrients and testing for antioxidant status to see if levels are adequate is advisable. Specific use of N-acetyl cysteine increases glutathione levels and is also advised. Use of several antioxidant supplements may be necessary for optimal results.

Homocysteine may be elevated in people with scleroderma. The higher the homocysteine level, the more progressive the disease. Screening for homocysteine can be extremely useful. Use of vitamin B
₆
, B
₁₂
, folic acid, and betaine (TMG) may be helpful in normalizing levels.

Low serum zinc levels have been found with frequency in people with scleroderma. In a recent study 17 people with localized scleroderma were given 60 to 90 mg of zinc gluconate daily. Fifty-three percent had benefits. Five people had partial remissions, and four people had complete remissions.

There is no single known cause of scleroderma. It is caused by a combination of genetics and environmental factors. Evidence suggests that prolonged exposure to silica, silicone, and chemical solvents significantly increases the risk of developing scleroderma.

In some individuals, solvents trigger the illness. An evaluation was made of 178 people with scleroderma, in comparison to 200 controls. People with scleroderma were more likely to have higher concentrations of and levels of exposure to solvents, especially trichloroethylene.

Silicosis has been well studied in scleroderma. People with silicosis from industrial exposure are 24 times more likely to be diagnosed with scleroderma. They are also two to eight times more likely to develop rheumatoid arthritis or systemic lupus erythematosus. Risk is greater in men. In a small study, 44 women and 6 men went through extensive testing and examination to see if there was a relationship between their work and autoimmune disease. They had been working for an average of six years in a factory that produced scouring powder with a high silica content. Thirty-two, or 64 percent, showed symptoms of a systemic illness, six with Sjögren’s syndrome, five with scleroderma, three with systemic lupus, five with a combination syndrome, and thirteen who didn’t fit into any definite pattern of disease. Seventy-two percent had elevated ANA (antinuclear antibodies), an indicator of autoimmune connective tissue diseases. The conclusion was that workers who are continually exposed to silica have a high probability of developing an autoimmune problem.

The research on breast implants is mixed. Silicone breast implants may also play a role in some women with scleroderma, yet no relationship between autoimmune antibodies was found (for rheumatoid arthritis, ANA, and Scl-70 for scleroderma). Twenty-six women with either lupus or scleroderma had breast implants removed. Three had complete remission of at least two years. Saline implants have a silicone casing that may also cause problems. If you have breast implants, testing for silicone and chemical antibodies would help you determine if you might benefit from their removal.

Natural therapies can work along with medical therapies for scleroderma. Infections must be treated and beneficial flora given. Nutrients that help with collagen maintenance and repair are essential to help prevent loss of elasticity in skin and organs. Consider supplementing with vitamin C, quercetin, zinc, glucosamine, and chondroitin. Foods and supplements that help reduce production of arachidonic acid will reduce inflammation and pain. Good-quality oils, fish, nuts, and seeds work in
this way. It’s also important to increase circulation and oxygen supply to the tissues. Finally, a nutrient-dense food plan must be developed that works to offset the problems of malnutrition, which are common.

Breath test for small intestinal bacterial overgrowth

Vitamin D levels

Comprehensive digestive stool analysis

Testing for food and environmental sensitivities

DHEA and cortisol testing

Liver function profile

Testing for silicone antibodies (for women with breast implants)