High-resolution esophageal manometry in systemic sclerosis in the indian population: An observational study

Abstract

Background: Systemic sclerosis (SSc) is a rare multisystemic autoimmune disorder in which the esophagus is the second most common organ to be affected after the skin, leading to dysmotility. Literature available on esophageal dysmotility in SSc is limited. Moreover, studies explaining the spectrum of esophageal dysmotility in the disease in the Indian population are sparse. Aim: The aim of this study was to characterize esophageal motility disorders in SSc using esophageal high-resolution manometry (HRM) in a representative of the Southwestern Indian population. Methods: Thirty-two SSc patients participated in the study. All of them met the inclusion and exclusion criteria and underwent esophageal HRM at the Gastrointestinal Physiology Laboratory, Department of Physiology, of our center. The findings were interpreted using the Chicago Classification v3.0 criteria. Results: Among patients of SSc with a mean age of 42.25 ± 10.45 years, 19 (59.38%) had “absent contractility (AC),” 3 (9.38%) had “ineffective esophageal motility (IEM),” 3 (9.38%) had “type I achalasia, 1 (3.13%) had “esophagogastric junction outflow obstruction,” and 6 (18.75%) had “normal” HRM findings. The HRM parameter of “basal lower esophageal sphincter pressure” differed significantly between “IEM type I achalasia” (P = 0.043) and “type I achalasia AC” groups (P = 0.032), while “median integral relaxation pressure” of “type I achalasia” groups showed significant difference with “normal, IEM, and AC” groups each (P < 0.001). Conclusions: The findings of the study suggest that varying degrees of esophageal motility disorders are present in SSc using HRM as defined by the Chicago Classification v3.0. Majority (59.38%) of patients had AC, but the rest of them showed other dysmotility patterns.

Keywords

• esophageal motility disorder
• high-resolution manometry
• lower esophageal sphincter
• systemic sclerosis