eating too soon before bedtime, but most people with scleroderma, medication is required to reduce the amount of acid produced by the stomach. Generally, the most effective drugs belong to a group called proton pump inhibitors. In Australia this includes Losec, Somac and Zoton. Foods to avoid include chocolate, coffee, citrus fruits, very fatty foods and alcohol. Stop smoking. Some people, particularly those that regurgitate food or acid up into the mouth will also benefit from a drug that tightens the lower oesophagal sphincter muscle and helps to improve the muscular contractions (peristalsis) in the oesophagus. These drugs include Prepulsid and Motilium.

If you have difficulty swallowing, (called dysphagia) make sure that you avoid foods that are difficult to chew, like tough meat. Eat sitting upright, and drink fluids after each mouthful. Some people find that they have less trouble if they have a glass of warm water before they eat. Thick, viscous liquids, like apricot nectar may help to get down pills. Once again, the drugs that improve the muscular contractions and tone of the sphincter can help.

Laxatives can help constipation it is good to start with something mild like Metamucil or Normacol People with very severe the advice of their medical practitioner.

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