Gastrointestinal Manifestations

Gastrointestinal (GI) problems are common and range from vague complaints of anorexia to life-threatening bowel perforation secondary to mesenteric arteritis. Anorexia, nausea, vomiting, and diarrhea may be related to the use of salicylates, NSAIDs, antimalarials, corticosteroids, and cytotoxic drugs.

SLE people who present with acute abdominal pain and tenderness need immediate, aggressive, and comprehensive evaluation to rule out an intra-abdominal crisis. Ascites, an abnormal accumulation of fluid in the peritoneal cavity, is found in about 10 percent of SLE people. Pancreatitis is a serious complication occurring in approximately 5 percent of SLE people and is usually secondary to vasculitis.

Mesenteric or intestinal vasculitis is a life-threatening condition that may have complications of obstruction, perforation, or infarction. They are seen in more than 5 percent of people with SLE. Abnormal liver enzyme levels are also found in about one-half of SLE people (usually secondary to medications). Active liver disease is rarely found.