Esophageal dysmotility in scleroderma: A prospective study of 183 cases

Lahcene, M.; Oumnia, N.; Matougui, N.; Boudjella, M.; Tebaibia, A.; Touchene, B.

doi:10.1016/j.gcb.2009.01.014

Cited by 27 publications

(8 citation statements)

References 16 publications

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“…Hypoperistalsis has been noted in 48%–81% of cases while aperistalsis in 23%–52% of patients [ 39 ]. Lahcene et al [ 40 ] studied the prevalence and risk factors of esophageal motor disorders in systemic sclerosis and found the prevalence of esophageal motor disorders in 81% of patients and a hypotensive lower esophageal sphincter in 62% of the patients. Another study by Savarino, et al [ 41 ] evaluated retrospectively abnormalities of esophageal motility, gastric emptying, oro-cecal transit time (OCTT) and small intestine bacterial overgrowth (SIBO) in a large cohort of SSc patients.…”

Section: Discussionmentioning

confidence: 99%

Assessment of esophageal involvement in systemic sclerosis and morphea (localized scleroderma) by clinical, endoscopic, manometric and pH metric features: a prospective comparative hospital based study

et al. 2015

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BackgroundSystemic sclerosis (SSc) is a generalized disorder of unknown etiology affecting the connective tissue of the body. It affects the skin and various internal organs. Gastrointestinal tract involvement is seen in almost 90% of the patients. Esophagus is the most frequently affected part of the gastrointestinal tract. Esophageal motility disturbance classically manifests as a reduced lower esophageal sphincter pressure (LESP) and loss of distal esophageal body peristalsis. Consequently, SSc patients may be complicated by erosive esophagitis and eventually by Barrett’s esophagus and esophageal adenocarcinoma. Morphea, also known as localized scleroderma, is characterized by predominant skin involvement, with occasional involvement of subjacent muscles and usually sparing the internal organs. The involvement of esophagus in morphea has been studied very scarcely. The proposed study will investigate the esophageal involvement in the two forms of scleroderma (systemic and localized), compare the same and address any need of upper gastrointestinal evaluation in morphea (localized scleroderma) patients.Methods56 and 31 newly and already diagnosed cases of SSc and morphea respectively were taken up for the study. All the patients were inquired about the dyspeptic symptoms (heartburn and/or acid regurgitation and/or dysphagia). Upper gastrointestinal endoscopy, esophageal manometry and 24-hour pH monitoring were done in 52, 47 and 41 patients of SSc; and 28, 25 and 20 patients of morphea respectively.ResultsEsophageal symptoms were present in 39 cases (69.6%) of SSc which were mild in 22 (39.3%), moderate in 14 (25%), severe in three (5.3%); while only four cases (7.1%) of morphea had esophageal symptoms all of which were mild in severity. Reflux esophagitis was seen in 17 cases (32.7%) of SSc and only two cases (7.14%) of morphea. Manometric abnormalities were seen in 32 cases (68.1%) of SSc and none in morphea. Ambulatory 24-hour esophageal pH monitoring documented abnormal reflux in 33 cases (80.5%) of SSc and no such abnormality in morphea.ConclusionWhile the esophageal involvement is frequent in SSc, no such motility disorder is seen in morphea. Meticulous upper gastrointestinal tract evaluation is justified only in SSc and not in morphea.

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Section: Discussionmentioning

confidence: 99%

Assessment of esophageal involvement in systemic sclerosis and morphea (localized scleroderma) by clinical, endoscopic, manometric and pH metric features: a prospective comparative hospital based study

et al. 2015

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“…Gastroesophageal reflux disease is largely attributed to a hypotensive lower esophageal sphincter and dysmotility. 49 We recommend lifestyle modifications to all affected patients, including avoidance of alcohol and tobacco, sitting upright for at least 3 hours after meals, and elevation of the head of the bed. 50 Acid suppression with proton pump inhibitors or H 2 -receptor antagonists is the preferred initial therapy for symptoms of reflux in patients with scleroderma.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Gastrointestinal Involvement in Systemic Sclerosis

Miller

Gandhi²,

Clarke

et al. 2018

J Clin Rheumatol

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“…3). Asymptomatic esophageal dilatation and esophageal dysmotility are detected in up to 80% of patients [47]. Gastroesophageal reflux may play a role in the development and/or progression of SILD [48, 49].…”

Section: Other Significant Thoracic Diseasesmentioning

confidence: 99%

Imaging Lung Disease in Systemic Sclerosis

Strollo

Goldin

2010

Curr Rheumatol Rep

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Interstitial lung disease and pulmonary hypertension (PH) are the most common cardiopulmonary findings in patients with systemic sclerosis (SSc). About two thirds of patients suffering from SSc develop scleroderma interstitial lung disease. PH is present in about 20% of SSc patients and is typically associated with severe lung disease, although it may be an isolated manifestation of SSc. High-resolution CT scanning is a key method for evaluating chest involvement. There are four roles of imaging in scleroderma interstitial lung disease: 1) detection of lung involvement, 2) identification of patients likely to respond to treatment, 3) assessment of treatment efficacy, and 4) exclusion of other significant diseases to include PH and cardiac and esophageal abnormalities.

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Esophageal dysmotility in scleroderma: A prospective study of 183 cases

Cited by 27 publications

References 16 publications

Assessment of esophageal involvement in systemic sclerosis and morphea (localized scleroderma) by clinical, endoscopic, manometric and pH metric features: a prospective comparative hospital based study

Assessment of esophageal involvement in systemic sclerosis and morphea (localized scleroderma) by clinical, endoscopic, manometric and pH metric features: a prospective comparative hospital based study

Gastrointestinal Involvement in Systemic Sclerosis

Imaging Lung Disease in Systemic Sclerosis

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