POS0942 QUANTIFYING THE PREVALENCE OF DISORDERS OF GUT BRAIN INTERACTION IN SYSTEMIC SCLEROSIS

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Background: Systemic sclerosis (SSc) is a rare autoimmune disease that affects multiple organ systems, with up to 90% of patients reporting gastrointestinal (GI) symptoms [1]. SSc GI involvement is characterised by dysmotility, presenting with symptoms of heartburn, bloating, diarrhoea and constipation. The pathophysiology of SSc GI involvement is incompletely understood with the aetiology of common symptoms likely complex and multi-factorial [2]. Disorders of gut brain interaction (DGBI), most frequently manifest as irritable bowel syndrome (IBS) and functional dyspepsia, are defined by abdominal symptoms in the absence of structural abnormalities and diagnosed by application of the Rome IV diagnostic criteria [3]. However, it is recognised that there is disordered GI motility and emerging evidence of abnormal immune activation in individuals with DGBI [4]. DGBI can co-exist with other organic GI diseases such as inflammatory bowel disease, with a four-fold increased prevalence of IBS in those with inflammatory bowel disease [5]. Objectives: To describe the prevalence of patients with SSc who meet Rome IV diagnostic criteria for DGBI. Secondly, we evaluated the association between quality of life (QoL) and daily function and DGBI in patients with SSc. Methods: 96 individuals with SSc according to 2013 ACR/EULAR criteria, recruited from a single SSc centre, completed the Rome IV Diagnostic Questionnaire, Short Form 36 (SF-36) to assess QoL, Health Assessment Questionnaire Disability Index (HAQ DI) to assess daily function, and UCLA GI 2.0 Questionnaire (GIT 2.0) to assess SSc GI severity. Descriptive statistics were applied to describe the prevelance of DGBI. Linear regression analysis was used to evaluate the association between DGBI and SSc GI severity. Median scores of QoL and daily function were compared between those with and without DGBIs using Wilcoxon rank sum test. Results: Twenty-one (21.88%) SSc patients met criteria for functional dyspepsia and 18 (18.75%) met criteria for IBS. Fifteen (15.63%) and 12 (12.50%) patients met criteria for functional constipation and diarrhoea respectively. Seven (7.29%) patients met criteria for functional bloating The median total GIT 2.0 score was 0.44 [0.13-0.92]. Linear regression analysis demonstrated individuals who met criteria for IBS were more likely to have more severe SSc GI disease as measured by the GIT 2.0 (total GIT 2.0 score: coef 0.75 [0.52-0.99], p<0.01), as well as higher individual GIT 2.0 component scores. SSc patients who met criteria for functional dyspepsia had higher total GIT 2.0 scores (coef 0.68 [0.45-0.90], p<0.01) as well as all higher individual component scores except the constipation component score. A similar pattern of effect on GIT 2.0 severity scores was noted in patients who met criteria for functional diarrhoea, with functional diarrhoea associated with higher total GIT 2.0 scores (coef 0.77 [0.48-1.06], p<0.01) and all individual GIT 2.0 component scores except constipation (Table 1). QoL and daily function were only variably associated with DGBI. Functional dyspepsia was associated with poorer physical QoL whilst IBS and functional bloating were associated with worse mental QoL. Despite numerically poorer daily function scores in those meeting criteria for most DGBIs evaluated, the difference in HAQ DI scores did not meet statistical significance (Table 2). Conclusion: One fifth of SSc patients surveyed met criteria for IBS or functional dyspepsia, the two most common DGBI. Whilst SSc GI involvement is characterised by structural and functional abnormalities, the high prevalence of patients meeting criteria for DGBI raises the possibility these patients may derive symptomatic benefit from the implementation of DGBI specific management strategies in addition to their usual SSc treatment. REFERENCES: [1] Quinlivan et al Arthritis Care Res 2024 76 1686. [2] McMahan et al Nat Rev Rheumatol 2023 19 166. [3] Drossman et al Gastroenterol 2016 150 1257. [4] Vanuytsel et al Gut 2023 72 787. [5] Halpin et al Am J Gastroenterol 2012 107 1474. Table 1 . Acknowledgements: NIL . Disclosure of Interests: Kate Seaton: None declared, Laura Ross: None declared, Chamara Basnayake Completed the following talks at these companies: (all were general education sessions not to do with their specific products): Dr Falk Pharmaceuticals, Ferring pharmaceuticals, Takeda, Dr Reddys, Dr Reddys, Alannah Quinlivan: None declared, Wendy Stevens Paid Honoraria with BI, GSK, Jannsen, MSD, Australian Scleroderma Interest Group (ASIG) received funding from Janssen and BI, Nava Ferdowsi Speaker for AbbVie. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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