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Related Experiment Videos

Esophageal disease in scleroderma.

Ellen C Ebert1

  • 1UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA. jeydels@comcast.net

Journal of Clinical Gastroenterology
|October 4, 2006
PubMed
Summary
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Progressive systemic sclerosis (PSS) causes esophageal dysmotility and complications like strictures. Diagnosis and treatment remain uncertain, highlighting the need for further clinical studies.

Area of Science:

  • Gastroenterology
  • Rheumatology
  • Pulmonology

Background:

  • Progressive systemic sclerosis (PSS) significantly impacts esophageal function, leading to smooth muscle atrophy and fibrosis.
  • This results in reduced peristalsis and altered lower esophageal sphincter pressure, causing symptoms like dysphagia and reflux.
  • Complications such as strictures and Candida esophagitis can arise, with esophageal disease potentially correlating with pulmonary involvement.

Purpose of the Study:

  • To review the current understanding of esophageal disease in PSS.
  • To identify uncertainties in diagnosis and treatment strategies.
  • To highlight areas for future clinical research.

Main Methods:

  • Literature review of studies on PSS and esophageal involvement.

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  • Analysis of diagnostic methods including manometry, cine-esophagram, and pH monitoring.
  • Evaluation of reported complications and treatment approaches.

    • Main Results:

    • Esophageal dysmotility is a key feature of PSS, affecting peristalsis and sphincter function.
    • Complications include strictures (17-29%) and Barrett esophagus (0-37%); Candida esophagitis is specific to PSS reflux.
    • Correlation exists between esophageal and pulmonary disease, but not with gastrointestinal involvement.
    • Symptom correlation with objective findings (esophagitis, pH) is poor, complicating treatment decisions.

    Conclusions:

    • Significant uncertainties exist in diagnosing and managing esophageal disease in PSS.
    • The role of reflux in pulmonary disease associated with PSS requires further investigation.
    • Clinical studies are needed to clarify optimal diagnostic and therapeutic strategies, including medication choices and aspiration precautions.