TITLE:
Gastrointestinal Manifestations of Autoimmune Diseases: Diagnostic Implications for Frontline Clinicians
AUTHORS:
David Fernando Ortiz-Pérez, Richard Alexander Revelo-Arcos, Juan José López-Diago, Juan David Pantoja-Torres, Edwar Alexsander Pillimue-Muelas, Aldwin José Triana-Pomare, Fabio Andrés Velasco-Vasquez, Camilo Andres Valencia Urquina, Cindy Marcela Mercado-Pineda, John Jairo Jaramillo-Baena, Grey Paola Castañeda-Ortega, Jhon Alexander Pérez-Sanmiguel, María Alejandra Jelkh-Salazar
KEYWORDS:
Autoimmune Diseases, Gastrointestinal Manifestations, Systemic Lupus Erythematosus, Systemic Sclerosis, Autoimmune Hepatitis
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.13 No.10,
October
23,
2025
ABSTRACT: Systemic autoimmune diseases are a significant cause of morbidity and healthcare resource utilization and frequently present with nonspecific gastrointestinal (GI) manifestations such as abdominal pain, dyspepsia, nausea or vomiting, diarrhea, that hinder timely diagnosis. This narrative review synthesizes recent evidence on early GI symptoms and their value as an early “diagnostic window.” We address key entities with digestive involvement—including systemic sclerosis, celiac disease within the autoimmune spectrum, autoimmune gastritis, autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and autoimmune pancreatitis—emphasizing their presentation, initial evaluation, and early management. We also discuss shared pathophysiological mechanisms that account for clinical heterogeneity and support an integrative approach. Recognizing digestive “red flags” at the first point of contact enables shortening the diagnostic gap, initiating organ-directed and immunomodulatory treatments in a timely manner, and reducing complications. Finally, we identify gaps in the literature and the need for biomarkers and prospective cohorts to drive more precise diagnostic and therapeutic strategies.