Esophageal motility abnormalities in systemic sclerosis

Scleroderma is a systemic disease in which the achievement of motility of the esophagus is the most common visceral involvement. Esophageal manometry is the best examination to detect this disorder. The aim of this study is to evaluate the contribution of manometry in the diagnosis of esophageal involvement in scleroderma, to analyze motor disorders observed, and to assess their frequency. Our study involved 477 consecutive patients with confirmed systemic sclerosis, referred to our department between January 1997 and December 2010. All of these patients underwent esophageal manometry. Esophageal motor disorders were observed in 275 patients (57.6%) and 268 (56.2%) had a typical manometric recording of scleroderma. Out of the 299 asymptomatic patients, 150 (50.2%) had an abnormal manometric tracing and 63 (21.1%) had severe disorders of esophageal motility. The disorders found on manometry were represented by: a decrease in the pressure of lower esophageal sphincter (58.3%), a decrease of a percentage of lower esophageal sphincter relaxation. (17.8%), decrease in the contraction amplitude (37.9%), and aperistalsis (40%). Our study underlines the importance of esophageal manometry during systemic sclerosis to identify the abnormalities which were frequent, even though esophageal symptoms were absent.