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[Systemic scleroderma. Contribution of esophageal manometry].

M Veyrac, L Meunier, J P Aubin

    Presse Medicale (Paris, France : 1983)
    |May 24, 1986
    PubMed
    Summary

    Progressive systemic sclerosis often causes esophageal motor dysfunction, leading to gastroesophageal reflux. Early diagnosis of esophageal motility issues is crucial for preventing complications.

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    Area of Science:

    • Gastroenterology
    • Rheumatology
    • Pulmonology

    Context:

    • Progressive systemic sclerosis (PSS) is a multisystem autoimmune disease.
    • Esophageal involvement is common in PSS, affecting motility and potentially leading to complications.
    • Oesophageal manometry is a key diagnostic tool for assessing esophageal motor function.

    Purpose:

    • To investigate oesophageal motor function using oesophageal manometry in patients with progressive systemic sclerosis.
    • To correlate manometric findings with the type of scleroderma (proximal vs. diffuse).
    • To explore the relationship between oesophageal dysfunction, gastro-oesophageal reflux, and respiratory compromise.

    Summary:

    • Oesophageal manometry was performed on 48 patients with PSS (25 proximal, 23 diffuse).

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  • Oesophageal lesions were observed in 70% of patients, but classical scleroderma manometric signs were present in only 31%.
  • Aperistaltic areas were noted, particularly in the proximal scleroderma group, suggesting early peristaltic modifications.
  • Oesophageal motility abnormalities and low lower oesophageal sphincter pressure contribute to gastro-oesophageal reflux and may impact respiratory function, especially in diffuse scleroderma.

    • Impact:

    • Findings highlight that oesophageal lesions are frequent in PSS, but classical manometric signs are less common.
    • Suggests potential early oesophageal motility changes at the junction of muscular coats.
    • Emphasizes the link between oesophageal dysfunction, reflux, and respiratory compromise in diffuse PSS.
    • Recommends early prevention of gastro-oesophageal reflux upon diagnosis of oesophageal motility abnormalities.