Esophageal dysfunction in patients with progressive systemic sclerosis and mixed connective tissue diseases

Area of Science:

• Gastroenterology
• Rheumatology
• Clinical Physiology

Background:

• Progressive systemic sclerosis (PSS) and mixed connective tissue disease (MCTD) are autoimmune disorders that can affect various organ systems.
• Esophageal dysfunction is a known complication of connective tissue diseases, impacting patient quality of life.

Purpose of the Study:

• To evaluate esophageal motility using manometry and radiological examination in patients with PSS and MCTD.
• To compare esophageal function in patients with PSS and MCTD to healthy controls.
• To correlate manometric and radiological findings with the symptom of dysphagia.

Main Methods:

• Esophageal manometry with open tube and continuous perfusion was performed on 37 PSS patients, 12 MCTD patients, and 40 controls.
• Radiological examination (barium swallow) was conducted on all participants.
• Patient-reported dysphagia symptoms were recorded.

Main Results:

• Radiological abnormalities, primarily slow transit time, were observed in 15/37 PSS and 3/12 MCTD patients.
• Manometry revealed esophageal body abnormalities in 17/37 PSS and 6/12 MCTD patients, most commonly lack of contraction in mid-lower esophagus.
• Lower esophageal sphincter pressure was significantly reduced in both PSS and MCTD patients compared to controls. Dysphagia was reported by 10 PSS and 6 MCTD patients, being more frequent in MCTD.

Conclusions:

• Esophageal motility and structural abnormalities are common in patients with PSS and MCTD.
• Reduced lower esophageal sphincter pressure is a significant finding in these patient groups.
• While radiological and manometric findings were similar between PSS and MCTD, dysphagia was more prevalent in MCTD patients.