Delayed gastric emptying in patients with diffuse versus limited systemic sclerosis, unrelated to gastrointestinal symptoms and myoelectric gastric activity

Objective: To study the gastric function in patients with diffuse and limited systemic sclerosis (SSc) in relation to the degree of upper gastrointestinal symptoms. Methods: Scintigraphic gastric emptying and recording of the myoelectric signals of the stomach were examined in 15 patients with diffuse SSc (dSSc), 13 patients with limited SSc (lSSc) and 15 healthy controls. The frequency of upper gastrointestinal symptoms was determined using a questionnaire. Results: Patients with dSSc had slower gastric emptying ( scintigraphic gastric half-emptying time median (Md) 103 min, range 75 - 447 min) than control subjects ( Md 70 min, range 38 - 94) and patients with lSSc ( Md 76 min, range 43 - 460). Electrogastrographic recordings did not differ between dSSc, lSSc or controls. Symptoms tended to be more abundant in dSSc patients than in lSSc patients, however, patients with a high frequency of symptoms did not differ from patients with low frequency of symptoms in gastric function, as measured with scintigraphic gastric emptying or electrogastrography ( EGG). Neither EGG nor a thorough review of upper gastrointestinal symptoms could predict delayed gastric emptying. Conclusion: The higher prevalence of delayed gastric emptying in patients with dSSc in this study indicates a more severe involvement of the gastrointestinal tract in dSSc than in lSSc, and stresses the importance of differentiating between the subtypes of SSc patients. Since EGG dysrythmia did not correlate with gastric emptying we concluded that factors other than defective myoelectric signals might contribute to a disturbed gastric function.