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Introduction Gastrointestinal involvement (GI) is a common manifestation in systemic sclerosis (SSc), affecting multiple parts of the digestive tract and significantly impairing the patient’s quality of life. Currently, no data support a correlation between multidomain patient-reported outcome measures (PROMs) and organ-specific damage in systemic sclerosis (SSc), including upper digestive tract impairment.Material and Methods This retrospective study included 74 patients with SSc, randomly selected from Sfanta Maria Clinical Hospital in Bucharest. All patients met the ACR-EULAR Classification Criteria for SSc. In addition, the study received approval from the ethics board and informed consent was collected from all patients through signed forms. Disease activity was evaluated using the SCTC-AI and EScSG-AI, while progression of the disease was assessed through MSS. Data examinations were conducted using the Mann-Whitney U test and Spearman’s correlation coefficient.Results The study involved 87.84% women, 51.35% patients with limited type of the disease, 47.30% with diffuse type and 1.35% sine scleroderma, with a mean age of 57.7±1.25 years and a mean span of the disease of 10.96±1 years. Patients with upper digestive tract impairment reported statistically higher values in all of the scores than individuals without superior GI tract dysfunctions SSc-related: ScleroID (4.647±0.287 vs 2.883±0.372, p=0.002), SCTC-AI (17.55±2.071 vs 9.722±3.153, p=0.009), EscSG (4.616±1.006 vs 1.583±0.318, p=0.0006) and MSS (7.232±0.46 vs 4.556±0.606, p=0.0014). Regarding ScleroID question on upper GI symptoms (question number three), such as vomiting, swallowing difficulties and reflux), showed positive corellations with all damage indices: SCTC-AI (r=0.393, p=0.0005), EScSG-AI (r=0.375, p=0.001) and with Mesdger’s severity scale (r=0.343, p=0.002).In contrast, the subdomain addressing limitations of life choices and activities in patients with superior digestive tract involvement (question number seven), showed no significant correlation wtih any damage indices (SCTC-AI r=0.128, p=0.3449; EScSG-AI r=0.1686; p=0.214) or with MSS (r=0.133, p=0.328). The mean value of question number seven in individuals with proximal digestive tract impairment was significantly higher than in those without this condition (5.393±0.372 vs 3.556±0.696, p=0.018).Conclusions Patients with significant esophageal symptoms showed significantly higher scores across all assessment tools, suggesting a strong association between upper gastrointestinal dysfunction and overall disease activity. Notably, there remains a striking contrast between the digestive symptom burden and the perceived impact on daily activities and life choices. This may suggest that patients develop coping mechanisms or underreport functional limitations, particularly in chronic conditions or those with an insidious onset. Such observations advocate for the systematic integration of PROMs within a broader, patient-centered assessment framework.