Constrictions of the small blood vessels around the nerves that control the muscles of the esophagus can lead to problems when swallowing food. Patients may have a sensation of choking, with food getting trapped in the upper-middle chest. In rare instances, the decreased motility may involve not only the esophagus but also lower segments of the gastrointestinal tract. The slow progression of food through the lower tract may allow excessive growth of bacteria and produce diarrhea and abdominal cramps. Fibrotic component .
Fibrosis is a process that follows chronic inflammation in the progression of scleroderma.
Initially, the excess of collagen produces thick, tight skin and resultant pain and burning. This problem is easily diagnosed and requires no laboratory or special testing. Fibrotic changes within the lung tissue may parallel the changes in the skin, giving rise to symptoms of chronic inflammation. Repeated testing of the lung function allows the doctor to follow the response to treatment. Autoimmune component .