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Esophageal dysfunction and its pathogenesis in progressive systemic sclerosis

T R Weihrauch, G W Korting, K Ewe

    Klinische Wochenschrift
    |October 1, 1978
    PubMed
    Summary
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    Esophageal dysfunction is common in systemic sclerosis, often without noticeable symptoms. This study suggests muscle atrophy and sclerosis cause these motor abnormalities, highlighting the need for objective testing.

    Area of Science:

    • Gastroenterology
    • Rheumatology
    • Internal Medicine

    Background:

    • Progressive systemic sclerosis (PSS) frequently affects the esophagus.
    • Esophageal involvement in PSS can lead to significant morbidity.
    • Objective assessment is crucial as symptoms may be absent.

    Purpose of the Study:

    • To prospectively evaluate esophageal involvement in patients with PSS.
    • To correlate subjective symptoms with objective radiological and manometric findings.
    • To investigate the pathogenesis of esophageal motor dysfunction in PSS.

    Main Methods:

    • Prospective study of 25 PSS patients.
    • Analysis of subjective symptoms, radiological, and manometric criteria.
    • Pharmacological testing with carbachol and pentagastrin in a subset of patients and controls.

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    Main Results:

    • Abnormal esophageal motility detected in 72% (radiology) and 88% (manometry) of patients.
    • Dysphagia present in only 44% of patients.
    • Six patients (24%) had severe objective abnormalities without subjective symptoms.
    • Pharmacological tests suggest primary myogenic genesis due to smooth muscle atrophy and sclerosis.

    Conclusions:

    • Absence of esophageal symptoms does not rule out advanced esophageal disease in PSS.
    • Esophageal dysfunction in PSS likely stems from primary myogenic changes in the esophageal smooth muscle.
    • Objective diagnostic methods are essential for identifying esophageal involvement in PSS.