How To Diagnose Scleroderma?
Scleroderma
Scleroderma is an autoimmune disease or group of autoimmune diseases that may result in skin thickening, scarring, changes to blood vessels, muscles, and internal organs.
Scleroderma is classified as localized or widespread (Systemic scleroderma) which depends upon the affected internal organs. It is further divided into limited and diffuse scleroderma which is based upon the extent of cutaneous involvement.
What are the Signs and Symptoms of Scleroderma?
The signs and symptoms of patients with scleroderma may range from mild to severe and in some cases, may be life-threatening. Symptoms may vary from person to person and time.
Examples:
- Raynaud phenomenon
- Joint pain, joint rigidity
- Hardening and thickening of the skin
- Swelling of hands and feet
- Gastroesophageal reflux and difficulty in swallowing food
- Fatigue and muscle weakness
- Dryness of mouth and mucous membranes
- Loss of appetite
- Weight loss
- Constipation and diarrhea
- Malnutrition
What Causes Scleroderma?
Scleroderma is caused due to overproduction and deposition of collagen in body tissues. Collagen is a fibrous protein that makes the body to produce connective tissue including skin, internal organs, and blood vessels, and support muscles and bones.
The exact cause of abnormal and excess collagen production is not known but the immune system of the body appears to play a role in the production of excess collagen.
Scleroderma is caused by a combination of various factors, including genetic factors, environmental factors, and immune system problems.
How to Diagnose Scleroderma?
The diagnosis of scleroderma is difficult because it can occur in many forms and it can affect different parts of the body. Diagnosis of scleroderma is chiefly based upon signs and symptoms. The doctor asks the patient about their medical history, do a proper physical examination of the patient and after complete monitoring suggests various lab tests and X-rays. The signs and symptoms of patients having scleroderma may range from moderate to debilitating and it may be life-threatening. No single blood test can diagnose scleroderma, although many antibodies are associated with this condition.
Some of the Symptoms Present in Scleroderma Patient are the following:
Reynaud’s phenomenon that includes color changes, numbness, finger swelling, skin ulcers, pain and gangrene on the fingers and toes
- Skin thickening and tightening
- Heartburn
- Difficulty in swallowing food
- Constipation
- Weight loss
- Shortness of breath
- Joint pain
Various tests that can Help in the Diagnosis of Scleroderma are the following:
If scleroderma is suspected in the patient, tests will be performed to confirm the diagnosis, as well as to evaluate the severity of the disease. These tests may include pulmonary function tests or breathing test, electrocardiogram, echocardiogram, gastrointestinal tests, kidney function, CT chest scan, X-rays or special imaging, Motility studies, urinalysis, thyroid function tests, skin biopsies.
- Pulmonary Function Tests:
Pulmonary function tests or breathing tests are performed to estimate how properly the lungs are working. It is important to verify that is it spread to the lungs or not because it can lead to scar tissue formation. This test comes under non-laboratory test and performed by X-ray or computed tomography to check flung damage.
- Electrocardiogram:
Scleroderma can also affect the heart of the patient, and cause scarring of the heart tissue. This can lead to congestive heart failure and inadequate electrical movement of the heart. This test is performed to examine whether the scleroderma has affected the heart and changes in the heart muscle tissue. An electrocardiogram (EKG/ECG) records the electrical activity of the heart, abnormal rhythms and identifies the damage.
- Echocardiogram:
The echocardiogram is an ultrasonogram of the heart. This test is also performed to examine the heart activity of the patient because scleroderma can affect the heart muscle tissue. The echocardiogram is suggested once every 6 to 12 months in patients of scleroderma for estimating complications like congestive heart failure or pulmonary hypertension. So echocardiogram is performed to check the structure and function of the heart. It uses sound waves to capture images of the heart and valves.
- Gastrointestinal Tests:
Scleroderma can affect the digestive tract of the patient which includes muscles of the esophagus and walls of the intestine. This can induce heartburn and difficulty in swallowing. It also affects the nutrients absorption and food movement through the intestine. In endoscopy, a small tube is inserted with a camera on the end which gives the clear picture of esophagus and intestines, and this test also measures the strength of the esophageal muscles.
- Kidney Function:
Scleroderma can also affect the kidneys, this can result in increased blood pressure as well as the release of protein into the urine. When scleroderma takes its serious form that is known as scleroderma renal crisis, a fast increase in blood pressure may occur and cause kidney failure. Blood tests are used to evaluate the Kidney function.
- CT Chest Scan:
This is a non-invasive X-ray that creates cross-section pictures of organs, bones, and other tissues. In CT scan or computed tomography scan, computer-processed combinations of many X-ray are used to measures the affected area and produce cross-sectional (tomography) pictures of particular area body.
- X-rays or Special Imaging:
In patients having scleroderma X-rays are done to evaluate the abnormalities and health of your lungs. X-rays may be performed to detect the deposits of calcium. The x-ray also gives information about the pulmonary volume loss.
X-rays or special imaging shows any changes in the bones or soft tissues produced by scleroderma. It uses a small amount of radiation to take photos of bones, organs and internal tissues.
- Motility Studies:
When scleroderma affects the small intestine of the patient, the sign and symptoms are similar to gastroparesis including bloating, nausea, and vomiting, and abdominal pain may also occur. Gastrointestinal motility belongs to the movement of food, liquid, and waste through the digestive system. When nerves or muscles in the gastrointestinal tract don’t work properly and produce symptoms related to motility disorders, the doctor recommended performing motility tests. This test includes esophageal function studies and anorectal manometry.
- Urinalysis:
A urinalysis test is performed in a patient having scleroderma to detect the leakage of protein in the urine. A urinalysis is used to identify and manage a broad range of disorders, such as kidney disease, urinary tract infections, and diabetes. A urinalysis includes the examination of concentration, appearance, and quantity of urine.
- Thyroid function tests:
In patients having scleroderma mainly in females, there is a large increase in thyroid-stimulating hormone level, antibody positivity, and antithyroid peroxidase which lead to an interference in thyroid function. So the doctor recommended thyroid function tests to evaluate the level of these hormones.
- Skin biopsies:
In skin biopsy, doctors take a small sample of patient’s skin and check under a microscope in a laboratory. Although skin biopsies can be effective but can’t diagnose the limited scleroderma. A skin biopsy may be performed to assess fibrosis in affected tissue.
- Thermography:
In thermography test, an infrared camera is used to detect heat patterns and blood flow within body tissues. It can classify the differences in skin temperature among the damaged and normal tissue.
- Antinuclear antibodies (ANA):
After a complete examination, the doctor may recommend an antibody nuclear (ANA) test, which shows the presence of any autoantibodies are in the blood. ANA is present in about 95% of people with scleroderma.Scl-70 antibody that is a scleroderma antibody, and anti-topoisomerase I antibody which shows positivity in up to 60% of adults having systemic sclerosis.Centromere antibody (ACA) or centromere pattern which is present in 50-96% of people having limited cutaneous scleroderma.
- Complete blood count (CBC) test:
This test is used to evaluate the level of red and white blood cells
- Comprehensive metabolic panel (CMP):
This is used to evaluate the function of organs and chemical and electrolyte balances.
Management of Scleroderma by Ayurveda
Planet Ayurveda provides effective and best herbal remedies for the treatment of scleroderma. All these herbal medicines are 100% safe, pure, vegetarian and easy to use and have no side effects.
Various products offered by Planet Ayurveda for treatment of scleroderma are Ashwagandha Capsules, Boswellia–Curcumin Capsules, Gotukola Capsules, Sanjivani Vati, Gandhak Rasayan.
Ashwagandha Capsules
These capsules contain pure extract of Ashwagandha herb (Withania somnifera) which is a traditional medicinal herb with various health benefits. These capsules help in improving overall health and provides strength to the body to fight against scleroderma. It can reduce anxiety and stress, increase fertility and testosterone in men, helps to treat depression and promote brain function. Use of ashwagandha supplement is an easy and useful way to improve health and quality of life. These capsules have the ability to improve the ‘Vata’ and ‘Pitta’ dosha of the body.
Dosages: 1 capsule twice daily.
Boswellia-Curcumin Capsules
These capsules are prepared by a combination of two potent herbs that are Shallaki (Boswellia serrata) and Curcumin (Curcuma longa). These capsules help to treat the scleroderma by supporting the immune system and cardiovascular system, joint functioning and improve blood supply to the joints.It is the best natural pain killer as well.
Dosages: 2 capsules twice daily after meal with plain water.
GotuKola Capsules
These capsules contain the pure extract of herb that is Gotu kola (Centella asiatica). Gotukola capsules treat scleroderma by balancing Pitta dosha of the body. It maintains the balance of three physical energies of the body – Satva, Rajas, Tamas. These capsules support healthy blood circulation in the body, maintain metabolic rate and also improve the memory.
Dosages: 2 capsules twice daily after meal with plain water.
Sanjivani Vati
This formulation is a combination of various herbs like Haritaki (Terminalia chebula), Sunthi (Zingiber officinale),Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica), Guduchi (Tinospora cordifolia), Pippali (Piper longum), Vacha (Acorus calamus), Shudha Bhallataka (Semecarpus anacardium), Vidanga (Embelia ribes), Shudha Vatsanabha (Aconitum ferox).
These tablets help to treat the autoimmune disorder, improve the liver functions and digestive system.
Dosages: 2 tablets twice daily after meal with plain water.
Gandhak Rasayan
These tablets are prepared by the pure Gandhak which is purified sulphur. Gandhak Rasayan tablets have anti-inflammatory, antiviral, antibacterial and antimicrobial properties. In patients of scleroderma,these tablets help to improve the health of skin and remove dead skin surface. It also improves the immune system and balance Vata, Pitta and Kapha doshas of the body.
Dosages: 2 tablets twice daily after meal with plain water.
Dietary Guidelines
Foods should be Taken
- Dark, leafy green vegetables
- Herbs and spices
- Multivitamin or mineral supplement
- Milk and yogurt
- Excess of water
Food should be Avoided
- Citrus fruits
- Tomato products,
- Greasy fried foods,
- Coffee,
- Garlic, onions, peppermint
- Gas-producing foods (like beans, raw peppers, broccoli or raw onions)
- Spicy foods
- Carbonated beverages and alcohol
