Gastrointestinal motility disorder assessment in systemic sclerosis

Area of Science:

• Gastroenterology
• Rheumatology
• Internal Medicine

Background:

• Systemic Sclerosis (SSc) is a generalized connective tissue disease.
• SSc commonly affects the digestive tract, leading to impaired gastrointestinal (GI) motility.
• Understanding the spectrum of GI involvement in SSc is crucial for patient management.

Purpose of the Study:

• To retrospectively evaluate oesophageal motility, gastric emptying, oro-cecal transit time (OCTT), and small intestine bacterial overgrowth (SIBO) in a large cohort of SSc patients.
• To compare GI motility parameters in SSc patients with healthy controls.
• To determine the prevalence of specific GI dysmotilities in SSc.

Main Methods:

• Ninety-nine SSc patients were included.
• Oesophageal manometry was performed in 42 patients.
• Gastric emptying time, OCTT, and SIBO were assessed using [(13)C]octanoic acid and lactulose breath tests in all patients.
• Data were compared to healthy controls.

Main Results:

• SSc patients exhibited significantly lower lower oesophageal sphincter pressure and wave amplitude compared to controls.
• Oesophageal involvement was present in 70% of SSc patients.
• Delayed gastric emptying (38%), delayed OCTT (median 160 min vs 105 min), and SIBO (46%) were significantly more frequent in SSc patients than in controls (P < 0.01 for all).

Conclusions:

• Gastrointestinal involvement is highly prevalent in Systemic Sclerosis.
• Oesophageal and small bowel dysmotility are common findings in SSc.
• While delayed gastric emptying is less frequent, SIBO is a significant issue in this patient population.