GI manifestations may be present in up to 50% of patients with SLE. Anorexia, nausea, and vomiting are among the most common. Oral ulcerations (most commonly buccal erosions) were identified in 40% of one group of patients. Esophageal involvement, as esophagitis, esophageal ulceration, or esophageal dysmotility, seems to correlate with the presence of Raynaud’s phenomenon. Intestinal involvement results in abdominal pain, diarrhea, and occasionally hemorrhage. Intestinal ischemia may be present and may progress to infarction and perforation. Pneumatosis intestinalis in SLE is usually benign and transient but may represent an irreversible necrotizing enterocolitis. In addition, pancreatitis and abdominal serositis are well-recognized. Abnormal liver functions also occur. A vasculitic process has been implicated in the pathogenesis of GI manifestations.
Reference: Wallace DJ: Gastrointestinal manifestations and related liver and biliary disorders. In Wallace DJ, et al (eds): Dubois’ Lupus Erythematosus, 4th ed. Philadelphia, Lea & Febiger, 1993, pp 410-417.