Scleroderma (progressive systemic sclerosis) is a systemic collagen disease in which the upper gut is frequently involved. In particular, most patient show altered esophageal motility, which frequently result in severe esophagitis, often resistant to therapeutic measures. The small bowel is also frequently involved by the disease, especially in the late stage of scleroderma. Small bowel alterations are sometimes clinically silent, but can also be the origin of malabsorption syndrome, small intestine perforation, pneumatosis cystoides or chronic intestinal pseudo-obstruction. The occurrence of an altered gastrointestinal motility in scleroderma can be detected by means of manometric techniques; their use in the wide area of collagenopathies may help understanding the pathophysiology of the altered gastrointestinal function frequently existing in these diseases.