# Nutrition in systemic sclerosis
Malnutrition and digestion
Malnutrition occurs regularly in systemic sclerosis and can become more severe as the disease progresses. This is related to changes in the oesophagus and gastrointestinal tract: the fibres can become stiffer and the transport of food slows down. For this reason, many patients eat less, eat less frequently, or feel full more quickly.
ProveniIncluded in official guidelines, or approved by EMA or FDA
That malnutrition occurs more frequently as involvement of the gastrointestinal tract increases.
It is important to regularly check whether you are eating enough and your weight remains stable. A dietitian can help with adapted meal schedules and structure, so that you get better nutrition without overloading your digestion.
Food intake with oesophageal problems
Many people with systemic sclerosis experience difficulty swallowing or have a burning sensation in the oesophagus. This can mean that certain foods — especially hard, dry or very hot foods — are difficult to get down. Smaller, more frequent meals and taking enough time to eat help many patients.
Body posture also plays a role: eating upright and remaining upright for a while after the meal can reduce reflux. Your doctor or dietitian can help you determine which nutritional choices work best for your situation, as this differs from person to person.
Liquid nutrition and nutritional drinks
When regular eating becomes difficult, nutritional drinks or supplements can help ensure you get enough calories and nutrients. These are available in many flavours and can be drunk cold or at room temperature, which sometimes feels better than hot meals.
Many patients experience that they feel better and have more energy when they get enough nutrients, even if this is through such supportive products. A dietitian can help you determine whether and how to use this best.
Salt and fluid balance
Systemic sclerosis can affect the kidneys and blood pressure. Some treatments require that you keep your fluid intake and salt intake in balance. Your doctor will give you specific guidance on this if it is relevant to your situation.
This is not something you can determine yourself — always discuss this with your doctor or dietitian, especially if you have high blood pressure or are taking medications that affect it.
Gastrointestinal health and dietary fibre
The intestinal flora (natural bacteria in the intestines) and the functioning of the gastrointestinal tract can become unbalanced in systemic sclerosis.
ResearchediPositive results in clinical studies, not yet standard treatment
is how certain food components and the composition of the intestinal flora are related to the severity and symptoms of the disease.
This research is ongoing, but it suggests that healthy gut function and nutrition may play a role together. A balanced eating pattern with sufficient fibre — as much as your digestion can handle — is generally recommended. Your dietitian can help you arrange your nutrition so that your intestines continue to work well without becoming overloaded.
Interactions between nutrition and medication
Some medicines that you take for systemic sclerosis can affect your appetite or interact with certain foods. This applies, for example, to certain medications for reflux, blood pressure or inflammation.
Making adjustments yourself is not advisable. Always discuss with your pharmacist or doctor how your medicines work best with food — they know your situation and can give you personal guidance.
Supplements and vitamins
Many patients consider additional vitamins or minerals, especially because preventing malnutrition is important. Whether and which supplements make sense depends on what exactly you are lacking and what your medicines do with them.
This is not something to experiment with yourself. Your doctor or dietitian can potentially suggest blood tests to detect deficiencies and can then give targeted advice.
Food choices and physical activity
A good nutrition pattern can help you maintain energy for activity and physiotherapy. When you have difficulty eating and at the same time notice that you are moving less because of the disease, this can be a vicious circle.
A dietitian familiar with systemic sclerosis can help you arrange your nutrition so you have energy for activities that are important to you — but this must always be coordinated with your full treatment team.
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_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._