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Achalasia-like syndrome in systemic sclerosis
R H Park1, J H McKillop, J J Belch
1Gastroenterology Unit, Royal Infirmary, Glasgow, UK.
The British Journal of Surgery
|January 1, 1990
Summary
Systemic sclerosis patients with severe dysphagia may have delayed esophageal emptying. Pneumatic dilatation can improve dysphagia in these patients when reflux esophagitis is absent.
Area of Science:
- Gastroenterology
- Rheumatology
- Clinical Medicine
Background:
- Dysphagia is a common symptom in systemic sclerosis.
- Oesophageal dysfunction significantly impacts quality of life for these patients.
Purpose of the Study:
- To evaluate oesophageal emptying in systemic sclerosis patients with dysphagia.
- To assess the efficacy of pneumatic dilatation for severe dysphagia in this cohort.
Main Methods:
- Oesophageal infusion scintiscan and timed Gastrografin swallow were used to quantify oesophageal emptying.
- Upper gastrointestinal endoscopy and oesophageal manometry were performed for further assessment.
Main Results:
- Eight of thirteen patients studied had dysphagia, with no endoscopic evidence of oesophagitis or stricture.
- Four patients exhibited delayed oesophageal emptying, absent peristalsis, and incomplete lower oesophageal sphincter relaxation, resembling achalasia.
- Two of these four patients showed significant improvement in dysphagia after pneumatic dilatation.
Conclusions:
- Delayed oesophageal emptying and aperistalsis are key findings in some systemic sclerosis patients with dysphagia.
- Pneumatic dilatation is a viable treatment option for severe dysphagia in systemic sclerosis when reflux oesophagitis is not present.