TY - JOUR
TI - Esophageal manifestation in patients with scleroderma
AU - Voulgaris, Theodoros A.
AU - Karamanolis, Georgios P.
JO - WORLD JOURNAL OF CLINICAL CASES
PY - 2021
VL - 9
TODO - 20
SP - 5408-5419
PB - BAISHIDENG PUBLISHING GROUP INC
SN - null
TODO - 10.12998/wjcc.v9.i20.5408
TODO - Systemic sclerosis; Esophagus; Gastroesophageal reflux disease;
Esophageal dysmotility; Proton pump inhibitors
TODO - The esophagus is the most commonly affected part of the gastrointestinal
system in patients with systemic sclerosis (SSc). Esophageal involvement
may lead to a significant reduction in patient quality of life. The
exact pathophysiology is complex and not yet fully elucidated.
Ultimately, esophageal smooth muscle becomes atrophied and replaced by
fibrous tissue leading to severe motility disturbance of the distal
esophagus. Symptoms are mainly attributed to gastroesophageal reflux
disease and to esophageal dysmotility. Compelling evidence has
correlated esophageal involvement to the severity of pulmonary disease.
No formed guidelines exist about the diagnostic modalities used to
assess esophageal disease in patients with SSc, though upper
gastrointestinal endoscopy is the first and most important modality used
as it can reveal alterations commonly observed in patients with SSc.
Further exploration can be made by high resolution manometry and
pH-impedance study. Proton pump inhibitors remain the mainstay of
treatment, while prokinetic agents are commonly used as add-on therapy
in patients with symptoms attributed to gastroesophageal reflux disease
not responding to standard therapy as well as to motility disturbances.
Gastroesophageal reflux disease symptoms in patients with SSc are
frequently difficult to manage, and new therapeutic modalities are
emerging. The role of surgical treatment is restricted and should only
be preserved for resistant cases.
ER -