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Advances in the Evaluation and Management of Esophageal Disease of Systemic Sclerosis

  • Scleroderma (J Varga, Section Editor)
  • Published:
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Abstract

Symptoms of heartburn and dysphagia as well as objective findings of abnormal esophageal acid exposure and esophageal dysmotility are common in patients with systemic sclerosis (SSc). Treatments for SSc esophageal disease are generally limited to gastroesophageal reflux disease (GERD) treatment with proton pump inhibitors. Progresses made in esophageal diagnostic testing offer the potential for improved clinical characterization of esophageal disease in SSc that may help direct management decisions. In addition to reviewing GERD management in patients with SSc, present and potential uses of endoscopy, reflux monitoring, manometry, impedance planimetry, and endoscopic ultrasound are discussed.

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Abbreviations

BE:

Barrett’s esophagus

dcSSc:

Diffuse cutaneous systemic sclerosis

EGD:

Esophagogastroduodenoscopy

EGJ:

Esophagogastric junction

EPT:

Esophageal pressure topography

HR(I)M:

High-resolution (impedance) manometry

lcSSc:

Limited cutaneous systemic sclerosis

LES:

Lower esophageal sphincter

MRS:

Multiple rapid swallows

GERD:

Gastroesophageal reflux disease

PPI:

Proton pump inhibitor

SIBO:

Small intestinal bacterial overgrowth

SSc:

Systemic sclerosis

UES:

Upper esophageal sphincter

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Acknowledgments

This work was supported by RO1 DK079902 (J.E.P.) and T32 DK101363-01 (J.E.P) from the Public Health Service. It was also supported in part by an NIH-NIAMS K23 AR059763 (M.H.) and a research award from the Scleroderma Research Foundation (MH).

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Dustin A. Carlson and Monique Hinchcliff declare no conflict of interest.

John E. Pandolfino reports grants and personal fees from Given Imaging as well as personal fees from Astra Zeneca and Takeda, outside the submitted work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Dustin A. Carlson.

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This article is part of the Topical Collection on Scleroderma

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Carlson, D.A., Hinchcliff, M. & Pandolfino, J.E. Advances in the Evaluation and Management of Esophageal Disease of Systemic Sclerosis. Curr Rheumatol Rep 17, 475 (2015). https://doi.org/10.1007/s11926-014-0475-y

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