SSc patients with UCLA distension/bloating “moderate-to-very severe” had statistically significant higher median LBP [11890 ng/ml (IQR 10540–14105) vs. 8170 ng/ml (IQR 7110–9476), p < 0.001] and Zonulin [0.96 ng/ml (IQR 0.89–1.33) vs. 0.86 ng/ml (IQR 0.82–0.99), p < 0.05] compared to SSc patients who reported “none-to-mild” symptoms at UCLA distension/bloating (Fig. 3C-D). This evidence concerns the gene HP and systemic sclerosis.