Esophageal dysfunction in scleroderma: relationship with disease subsets
| Autor: | Antonio Morelli, Gabrio Bassotti, Valeria Debernardi, Ugo Germani, Fabrizio Spinozzi, Giuseppina Buonafede, L. Dughera, Edda Battaglia, Pier Roberto Mioli, Paolo Puiatti, Fabrizio Quiriconi, Giorgio Emanuelli |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Systemic disease medicine.medical_specialty Manometry Immunology Esophageal Diseases Gastroenterology Scleroderma Esophagus Rheumatology Immunopathology Internal medicine medicine Immunology and Allergy Esophagitis Humans Pharmacology (medical) Aged Scleroderma Systemic Esophageal disease business.industry Incidence (epidemiology) Hydrogen-Ion Concentration Middle Aged medicine.disease Connective tissue disease Radiography medicine.anatomical_structure Female Esophagoscopy business Gastrointestinal Motility |
| Zdroj: | Arthritis and rheumatism. 40(12) |
| ISSN: | 0004-3591 |
| Popis: | Objective. To investigate the relationship between esophageal function and the extent of disease in a nonselected group of scleroderma patients, and to study gastric and small bowel motility in a group of scleroderma patients with more severe clinical manifestations. Methods. Esophageal function in 125 scleroderma patients was investigated by radiologic, endoscopic, manometric, and pH-metric techniques. Ten patients also underwent gastrointestinal (GI) manometric recording, both during fasting and after a standard meal. Results. Radiologic abnormalities of the esophagus were found in 55 of 81 patients (68%) and esophagitis in 45 of 125 (36%). No significant relationship was disclosed between GI symptoms, radiologic abnormalities, esophagitis grade, and the various disease subsets. However, the overall incidence of endoscopic esophagitis (irrespective of the degree) was significantly (P < 0.05) correlated with the patient subgroups, with 100% incidence of esophagitis in those having the more severe cutaneous involvement (type III). Manometric abnormalities were documented in 80% of patients, and pathologic reflux in 78%. The severity of esophageal abnormalities on manometry significantly correlated with the severity of the disease, whereas no correlations were found with pH-metric data. Ninety percent of the 10 female patients undergoing antroduodenal manometry displayed abnormal findings; of these, 60% showed neuropathic, and 30% myopathic, patterns. The latter were recorded in patients with a more severe stage of the disease (type III). Conclusion. A direct relationship was observed between scleroderma subsets and the severity of esophageal (and, probably, more distal gut) motor involvement. Since no correlation was found between esophageal symptoms and the severity of manometric abnormalities, manometry should be considered the single most important GI test to document the severity of the “esophageal” disease. Gastric and small bowel manometry may also offer evidence of widespread gut involvement, and provide a rationale for a more targeted therapeutic approach. |
| Databáze: | OpenAIRE |
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