I have had lupus, specifically systemic lupus erythematosus (SLE), for several years. I just read your article about the effects of lupus on the esophagus, which I am now experiencing. My question is: Could lupus have an effect on the intestines as well?

J.T.

Lupus is a chronic, inflammatory condition in which a patient's own immune system attacks his or her organs and tissues. Along with the kidneys, skin, joints and blood, the gastrointestinal system is frequently involved.

As you mention, lupus can cause abnormal muscle function in the esophagus, leading to difficulty in swallowing and acid reflux. But lupus can affect other areas of the GI tract as well. Inflammation of the pancreas (pancreatitis) can occur, causing abdominal pain and vomiting. Lupus can also lead to a build-up of fluid in the abdominal cavity, known as ascites, related to its effects on the inner lining of the abdomen.

To answer your question, the small intestine is often affected by lupus. This can lead to an inability to absorb nutrients properly. Patients with this condition may lose weight and have diarrhea despite eating a normal diet. However, the most potentially devastating gastrointestinal complication is disease of the arteries that supply the small intestine with blood. Patients with this condition (small intestinal vasculitis) may suffer from severe abdominal pain, nausea, vomiting and fever. If the condition is not detected early enough, intestinal tissue may begin to die because of insufficient blood supply. Emergency surgery may be required to remove the affected section of intestine. If the diagnosis is made earlier, the condition is treated with steroid drugs and occasionally other immunosuppressive agents.