Correlation of Esophageal Symptoms and Disease Subsets with Esophageal Manometric Assessment in Scleroderma

Cho, Young Jun; Lee, Yong Chan; Seo, Jung Hoon; Park, Hyo Jin; Lee, Soo Kon; Moon, Young Myoung; Park, In Suh

Abstract

BACKGROUND/AIMS: The aim of this study was to investigate the correlation between esophageal symptoms and disease subsets with esophageal manometric assessment in scleroderma.
METHODS
We performed esophageal manometry on thirty-three patients with scleroderma and normal controls from 1993 to 1998. Manometric findings were analyzed according to the presence of symptoms, endoscopic findings and the disease subsets.
RESULTS
Dysphagia and substernal pain were recognized in 13 patients (39%) out of total 33 patients. Twenty-two patients (67%) disclosed abnormal manometric findings and 16 patients (48%) showed decreased lower esophageal sphincter pressure (LESP). Sixteen patients (48%) revealed abnormal wave propagation and 15 patients (45%) showed decreased lower esophageal body pressure (LEBP). Ten patients showed both lower LESP and abnormal peristaltic wave. LESP of patients group was significantly decreased as compared with the controls (p<0.01). The amplitude of lower body contraction was decreased. There was no significant correlation between esophageal symptoms and disease subsets with abnormal manometric findings. Seven out of 22 patients with manometric abnormalites (32%) showed lung involvement which had no significant relation with esophageal dysmotility.
CONCLUSIONS
To detect early esophageal involvement, esophageal manometry should be used in the initial assessment of patients with scleroderma, regardless of the presence of esophageal symptoms and disease subsets.