Reviewed by Dr Andre Budihardjo, MM and Physician Brandon Yew

The Relationship Between Scleroderma and Gastroesophageal Reflux Disease

Published August 9, 2022| 6 min read

Does scleroderma trigger gastroesophageal reflux disease? Learn how it affects the gastrointestinal tract and ways to manage the disease holistically.

Woman looking uncomfortable while her chest with her left hand

Here’s a fun fact: The term scleroderma comes from the Greek words skleros and derma, which translates to hard and skin, respectively. It causes smooth muscle fibrosis – a development of fibrous connective tissues in response to injury or damage – within the smooth muscle layers, hardening skin.

Even more interesting, scleroderma can bring about gastroesophageal reflux disease (GERD), which presents as heartburn, difficulty swallowing or a lump in the throat. Raynaud’s phenomenon, where fingers and toes turn blue, white or red, is common too. This is due to the contraction of the small blood vessels in the fingers and toes in response to the cold or emotional distress.

Read on to understand the relationship between both diseases and how early intervention can help heal the former permanently.

skin disorder scleroderma — People who have scleroderma will experience skin hardening and tightening on the hands, feet and face.

Understanding How Scleroderma and Gastroesophageal Reflux Disease Co-exists

Oesophageal dysfunction commonly affects people with scleroderma. A ring of muscle called the lower oesophageal sphincter sits at the junction between the stomach and oesophagus. When a person isn’t swallowing, the sphincter will contract, preventing reflux and pushing gastric contents back into the oesophagus. However, this function is impaired in people with scleroderma, predisposing them to gastroesophageal reflux disease (GERD) symptoms.

One other function that is impaired in people with scleroderma is the rate of stomach emptying. People with scleroderma will have delayed emptying of the stomach (gastroparesis), another predisposing factor for GERD.

The Five Elements theory

Traditional Chinese Medicine (TCM) likens the onset of scleroderma and gastroesophageal reflux disease to the bond between a mother and son, according to Real Health Medical’s Senior Physician Brandon Yew.

Based on the Five Element theory, the Lungs, which govern the skin, are represented by the Metal element (the mother). The Spleen relates to the digestive system and represents the Earth element (the son).

“There are two scenarios involving this family of elements. Firstly, a person with scleroderma often presents with Lung syndrome. The Lungs’ (Metal element, mother) dysfunctions are passed to the Spleen (Earth, son) over time, provoking onset gastrointestinal disorders. This includes gastroesophageal reflux disease (GERD).

“Secondly, a person with GERD is perceived to have Spleen syndrome. If not promptly resolved, Lung health too, will become poor. This will trigger several skin conditions including scleroderma,” explains Physician Yew.

3D illustrations of a healthy digestive system and a digestive system with gastroesophageal reflux disease — When a person isn’t swallowing, the sphincter contracts, preventing reflux and pushing gastric contents back into the oesophagus. In people with scleroderma, this function is impaired.

A Multi-factor Treatment Plan for Scleroderma and Gastroesophageal Reflux Disease

Before delving into the available treatment options for scleroderma, remember that lifestyle modification can help prevent the disease’s onset. These include:

Exercising regularly
Getting sufficient, restful sleep
Maintaining work-life balance
Managing positive emotion control
Consuming a healthy and balanced diet

Limiting your consumption of alcoholic beverages and quitting smoking

Treating Gastroesophageal Reflux Disease with herbal formulas

Separately, herbal formulas and acupuncture can make a person less susceptible to gastroesophageal reflux disease by strengthening the Spleen and Stomach and dispelling pathogens like Cold, Fire, Dampness, phlegm, Blood Stagnation, and Qi (vital life force) Stagnation.

Examples of these are:

Li Zhong Wan (理中丸)

Xie Huang San (泻黄散)
Yi Wei Tang (益胃汤)
Zuo Jin Wan (左金丸)
Wu Zhu Yu Tang (吴茱萸汤)
Ban Xia Xie Xin Tang (半夏泻心汤)

Ge Xia Zhu Yu Tang (膈下逐瘀汤)
Zhi Shi Dao Zhi Wan (枳实导滞丸)
Zhi Shi Xiao Pi Wan (枳实消痞丸)
Xiang Sha Liu Jun Zi Tang (香砂六君子汤)

Prescription medications for symptomatic relief and overall well-being

Once a healthcare provider diagnoses a person with scleroderma, they may recommend medications to relieve symptoms, treat complications and maintain the functionality of several body parts.

A person’s prescription may include one of the following:

Lotions and moisturisers to calm skin itchiness
Corticosteroids or non-inflammatory, anti-steroidal pain relief medications
Medications that improve blood flow and regulate blood pressure
Immune system suppressing medications to slow skin hardening and reduce organ damage

Herbal formulas to treat scleroderma during the early stages

It’s possible to cure scleroderma permanently if a person seeks treatment promptly. Otherwise, TCM remedies may only be beneficial for alleviating disease symptoms. Herbal formulas can address scleroderma-associated syndromes, which are characterised by multiple pathological combinations and unique body constitutions of specific imbalances.

The herbal formulas that a licensed TCM practitioner will likely propose are:

Yin Qiao San (银翘散)
Bu Yang Huan Wu Tang (补阳还五汤)
Chai Ge Jie Ji Tang (柴葛解肌汤)
Dang Gui Si Ni Tang (当归四逆汤)
Jing Fang Bai Du San (荆防败毒散)

Shen Tong Zhu Yu Tang (身痛逐瘀汤)
Gui Zhi Shao Yao Zhi Mu Tang (桂枝芍药知母汤)
Huang Qi Gui Zhi Wu Wu Tang (黄芪桂枝五物汤)
Ma Huang Xi Xin Fu Zi Tang (麻黄细辛附子汤)

These formulas effectively dispel pathogens, restore the body’s vital elements – qi, blood, yin (passive energy) and yang (active energy) – and strengthen the Spleen and Lungs.

Stimulating acupressure points to remedy the underlying syndromes of scleroderma and GERD

Acupressure points can also be activated to relieve scleroderma and GERD symptoms. These are:

An illustration of taixi to improve kidney health — Located on the foot’s inner side, in the depression between the tip of the inner ankle bone and Achilles tendon. It revitalises the kidneys.

An illustration of a left hand, showing he gu (LI4) acupressure point — Located on the back of the hand, between the 1st and 2nd metacarpal bones. It helps dispel pathogens and restores and enhances qi and blood circulation within the meridians. * Nei guan (PC6): Located on the front of the forearm, 3-fingers breadth above the transverse crease of the wrist. It restores and enhances the heart’s function for improved qi and blood circulation within the meridians.

3D illustration of the Taichong (LV3) acupressure point — Located on top of the foot, in the depression closest to the 1st metatarsal space. It revitalises the liver.

Located on the front of the forearm, 3-fingers breadth above the transverse crease of the wrist. It restores and enhances the heart’s function for improved qi and blood circulation within the meridians.

Located along the midline of the lower abdomen, 4 fingers-breadth below the navel. It dispels pathogens for improved qi and blood circulation within the lower abdominal cavity and revitalises kidneys’ yang energy.

Located along the midline of the lower abdomen, 2 fingers-breadth below the navel. It dispels pathogens for improved qi and blood circulation within the lower abdominal cavity and revitalises kidneys’ yang energy.

Illustration of a foot with a red dot pointing at Tai Chong acupoint and another at San Yin Jiao acupoint — Pressing Tai Chong acupoint helps recuperate the qi, while San Yin Jiao acupoint helps nourish the kidneys, liver and spleen.

3D illustration of the zu san li acupoint — Located on the shin bone, 4 fingers-breadth below the depression of the knee joint, one finger-breadth (middle finger) from the anterior crest of the shin. It dispels pathogens to improve qi and fluid circulation within the meridians and revitalises the spleen and stomach.

Tai xi (KI3, 太谿)
He gu (LI4, 合谷)
Tai chong (LR3, 公孙)
Nei guan (PC6, 內关)

Guan yuan (RN4, 关元)
Qi hai (RN6, 气海)
San yin jiao (SP6, 三阴交)
Zu san li (ST36, 足三里)

If you notice your skin hardening, see a healthcare provider immediately. Early testing will increase your chances of beating scleroderma and stop gastroesophageal reflux disease from developing. Physician Yew also cautions, “It’s strongly advised that you don’t self-medicate using herbal formulas or ingredients without consulting a licensed TCM practitioner. Also, do note that acupressure only provides mild symptomatic relief and is incapable of tackling the root pathological reasons behind scleroderma.”