, Volume 19, Issue 5, pp 405-410

Upper gastrointestinal disease in rheumatoid arthritis

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Upper gastrointestinal series were done in 140 consecutive patients with rheumatoid arthritis, irrespective of the presence or absence of symptoms suggesting upper gastrointestinal disease. In addition, intraluminal pH and manometric studies of the esophagus and esophagoscopy were done in 66 of these 140 patients. Gastric ulcers were found in 12 patients, and duodenal ulcers in 27, an incidence of peptic ulcer disease of 27.8%. The higher incidence of ulcer disease was found in patients on corticoid and in combination with indomethacin or phenylbutazone. No ulcer occurred in patients receiving gold therapy. Of the 66 patients who had esophageal motility study, a significantly lower mean amplitude of peristaltic contractions was noted in the lower two-thirds of the esophagus. The resting pressure in the inferior esophageal sphincter was also significantly lower than in the control group. However, no correlation was found between these two parameters and the duration or ARA stages of rheumatoid arthritis. It is impossible to determine whether the upper gastrointestinal dysfunction observed in these patients is another systemic manifestation of the rheumatoid disease or due to drugs.