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Pulmonary function and gastroesophageal reflux in systemic sclerosis

M B Troshinsky1, G C Kane, J Varga

  • 1Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.

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Summary

In systemic sclerosis, abnormal gastroesophageal reflux does not appear to significantly impact lung function measures like total lung capacity or forced vital capacity. Smoking, however, was linked to reduced pulmonary function.

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Area of Science:

  • Rheumatology
  • Gastroenterology
  • Pulmonology

Background:

  • Systemic sclerosis is associated with esophageal dysfunction and gastroesophageal reflux.
  • Lung involvement, particularly interstitial lung disease, is a major cause of morbidity and mortality in systemic sclerosis.

Purpose of the Study:

  • To investigate the relationship between esophageal dysfunction, gastroesophageal reflux, and lung involvement in patients with systemic sclerosis.

Main Methods:

  • Retrospective review of esophageal manometry, 24-hour dual-probe esophageal pH monitoring, and pulmonary function tests in 39 patients.
  • Patients were categorized based on the presence of abnormal distal or proximal gastroesophageal acid reflux and abnormal distal esophageal peristalsis.

Main Results:

  • No significant association was found between abnormal gastroesophageal acid reflux (proximal or distal) and measures of lung volume (total lung capacity, forced vital capacity).
  • Smoking was identified as a confounder, negatively impacting diffusing capacity of the lungs for carbon monoxide (DLco).
  • Abnormal distal reflux was more prevalent in smokers.

Conclusions:

  • Lung volumes indicative of interstitial lung disease in systemic sclerosis patients do not seem to be directly related to abnormal gastroesophageal acid reflux.
  • Smoking is a significant factor affecting pulmonary function in this patient group.