[Clinical, endoscopic and manometric findings in the gastroesophageal tract of patients with systemic sclerosis].

BACKGROUND: In the systemic sclerosis (SSc) gastrointestinal manifestations are present up to 90 % and the esophagus is the most affected organ. The purpose was to investigate clinical, endoscopic and manometric upper gastroesophageal manifestations in patients with SSc.

METHODS: We studied 60 patients with SSc, mean age of 48 +/- 11 years and a mean disease evolution of 11 +/- 8 years. An endoscopy of gastro-esophageal tract and esophageal manometry were performed.

RESULTS: The clinical manifestations were: dysphagia 80 %, pirosis and regurgitations 78 %. Endoscopic findings were: esophagitis 60 %, hiatal hernia 65 %, loose hiatus 15 % and Barrett's esophagus 18 %. Manometric findings were hypotensive lower esophageal sphincter (LES) 95 %. Aperistalsis (41 %), slight hypomotility (30 %), severe hypomotility (27 %) were found. Gastric manifestations were: early satiety 45 %, abdominal pain 35 %, nausea 20 % and vomiting 10 %, and by endoscopy we observed: Gastric disturbances in 80 %, of these 40 % corresponds to non erosive gastropathy, 30 % to erosive gastropathy and 10 % to nodular gastropathy.

CONCLUSIONS: The most frequents endoscopic finding were esophagitis and hiatal hernia, and by manometry were aperistalsis and hypotensive LES. These alterations imply disorders of motility and dysfunction of LES. Barrett's esophagus was always associated with hiatal hernia.