Lupus and the digestive system

Lupus affects different people in different ways. Many people with lupus have problems with their digestive system.

How does lupus affect the digestive system?

The digestive system includes the digestive tract (mouth, esophagus, stomach, intestines, and anus) — as well as the liver, pancreas, and gallbladder.

Some digestive problems are caused by lupus itself, some are side effects of lupus treatments, and some have other causes (like infections). Your doctor can do tests to find out if your digestive problems are related to lupus.

Lupus and the mouth

Many people with lupus have ulcers (open sores) inside their mouths. Lupus can also cause inflammation of the gums. Regular visits to the dentist can help keep your mouth healthy.

Lupus and the esophagus

Lupus can cause inflammation in the esophagus and weaken the muscles you use to swallow.

When the muscle that connects your esophagus to your stomach is too weak, it can cause acid reflux (stomach acid moving backward to the esophagus). Acid reflux that lasts for a long time is called gastroesophageal reflux disease (GERD).

Symptoms of acid reflux and GERD include:

• Gas
• Heartburn
• Chronic cough
• Vomiting (throwing up)

Lupus and the stomach

People with lupus may develop peptic ulcers (open sores in the stomach lining) as a side effect of medications such as prednisone and NSAIDs. Symptoms include:

• Stomach pain
• Nausea (feeling like you’re going to throw up)
• Vomiting
• Dark bowel movements, which can indicate small amounts of blood in the stool (if your stool is dark black you should tell your doctor right away)

A type of bacteria called Helicobacter pylori (H. pylori) can also cause peptic ulcers. If H. pylori is causing your ulcers, your doctor may prescribe antibiotics to treat it.

Your doctor may order a test called an upper endoscopy to diagnose ulcers. Your doctor can also recommend medicines to help treat ulcers.

Lupus and the intestines

Lupus can rarely cause vasculitis (inflammation of the blood vessels) in the intestines, sometimes called lupus enteritis. Symptoms include:

• Abdominal pain (pain in the belly area)
• Feeling very full or bloated
• Diarrhea (watery poop)
• Nausea and vomiting
• Loss of appetite

Some people with lupus have other problems with their intestines, like irritable bowel syndrome (IBS). Symptoms of IBS include:

• Abdominal pain
• Gas
• Diarrhea
• Constipation (having trouble pooping)

Problems with the intestines can be side effects of NSAIDs and steroids — or they may be related to problems lupus can cause with the nervous system.

Lupus and the pancreas

Lupus can cause pancreatitis, or inflammation of the pancreas. Symptoms include:

• Abdominal pain that can spread to your back
• Nausea and vomiting
• Fever

Pancreatitis requires urgent medical attention. Pancreatitis can also be a side effect of azathioprine or steroids you take for lupus. Your doctor will do tests to find out what’s causing your pancreatitis before they treat it.

Lupus and the liver

Lupus and some lupus medicines can cause hepatitis, or inflammation of the liver. Most people with hepatitis don’t notice any symptoms, but symptoms can include:

• Fatigue (feeling tired)
• Jaundice (yellow skin and eyes)
• Nausea and vomiting

Learn more about how lupus affects the liver.

Lupus and the abdomen

Lupus can also cause other problems in the abdomen, including peritonitis (inflammation of the abdominal lining) and ascites (a build-up of fluids in the abdomen).

Symptoms of peritonitis and ascites include:

• Abdominal pain and swelling
• Nausea and vomiting
• Fever

Peritonitis and ascites can be caused by infections — or they may be related to another digestive system problem, like pancreatitis. Your doctor can do tests to find out what’s causing these problems and how to treat them.

Take steps to help protect your digestive system

While many digestive problems need medical treatment, making lifestyle changes may prevent or ease some symptoms.

Try these steps:

• Eat a healthy diet and be physically active
• Drink plenty of water, especially when you’re swallowing pills
• Get enough sleep — and avoid eating right before bedtime
• If you smoke, make a plan to quit
• If you drink alcohol, drink only in moderation
• Take steps to manage your everyday stress
• Protect yourself from infections

Depending on which digestive problems you have, your doctor can suggest other changes to help you feel better.

Find the right treatment plan

Because lupus can cause a lot of different digestive problems, there are many different medicines that can treat them. A special doctor called a gastroenterologist can work with your rheumatologist to find a treatment plan that works for you.

Learn more about medicines to treat lupus.

Keep an eye out for side effects

Remember that any medicine you take for lupus can have side effects. Talk with your doctors about what changes to watch for with the medicines you’re taking. And tell your treatment team right away if you have any side effects.

Watch this video for tips on managing side effects of lupus treatments.

If you have symptoms of digestive problems, tell your doctors right away. It’s important to treat these problems early, before they cause serious damage to the digestive organs.