Esophagitis in scleroderma. Prevalence and risk factors

Area of Science:

• Gastroenterology
• Rheumatology
• Esophageal Diseases

Background:

• Scleroderma frequently affects the esophagus, leading to complications like erosive esophagitis and stricture.
• The relationship between esophageal motility, gastroesophageal reflux, and these complications in scleroderma is not fully understood.

Purpose of the Study:

• To investigate the association between esophageal motility patterns and the presence of erosive esophagitis and stricture in patients with scleroderma.
• To determine if esophageal motility can predict the risk of developing these esophageal complications.

Main Methods:

• Esophagoscopy, biopsy, and esophageal manometry were performed on 53 patients with scleroderma.
• Lower esophageal sphincter pressures, gastroesophageal reflux episodes, and gastric emptying rates were assessed.
• Fungal infections were evaluated via smear and culture.

Main Results:

• 60% of patients had erosive esophagitis, often associated with abnormal distal esophageal motility (loss of peristalsis).
• Diminished lower esophageal sphincter pressures and increased reflux were common in patients with erosive esophagitis.
• Esophageal stricture was present in 13 of 32 patients with erosive esophagitis; normal motility ruled out esophagitis.

Conclusions:

• Esophageal motility patterns in scleroderma are key indicators for identifying patients at high risk for erosive esophagitis and stricture.
• Esophageal manometry can guide further investigations for esophageal complications in scleroderma, independent of symptom presentation.