Advertisement

Digestive Diseases and Sciences

, Volume 31, Issue 3, pp 225–229 | Cite as

Esophageal function, radiography, and dysphagia in Sjögren's syndrome

  • G. Kjellén
  • S. G. Fransson
  • F. Lindström
  • H. Sökjer
  • L. Tibbling
Original Articles

Abstract

Esophageal function and anatomy were investigated with manometry, acid perfusion test, acid clearing test, and x-ray in 11 patients with primary Sjögren's syndrom (SS) and in 11 with secondary SS. The manometric investigation revealed minor motor differences in the SS patients as compared to 16 controls, ie, shorter peristaltic contraction time of the whole esophagus, and faster peristaltic velocity preferably in the distal part of the esophagus, while the results from the reflux tests did not differ between patients and controls. Radiographic examination revealed upper esophageal webs in 10% (2/20), and hiatal hernia in 25% (5/20). The dysphagia as reported by 73% of the patients cannot be explained by webs or impaired motor function and is regarded to be secondary to lack of saliva, making the solid bolus passage difficult.

Keywords

Hiatal Hernia Clearing Test Esophageal Function Peristaltic Contraction Impaired Motor Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Carlsöö B, Ström T, Östberg Y: Sjögrens syndrom—en multidiciplinär sjukdom. Läkartidningen 76:1204–1208, 1979Google Scholar
  2. 2.
    Morgan WS, Castleman B: A clinicopathological study of “Miculicz's disease”. Am J Pathol 29:471–503, 1953Google Scholar
  3. 3.
    Hradsky M, Hybasek I, Cernoch V, Sazomova V, Juran J: Oesophageal abnormalities in Sjögren's syndrome. Scand J Gastroenterol 2:200–203, 1967Google Scholar
  4. 4.
    Ramirez-Mata M, Pena-Ancira FF, Alarcon-Segovia D: Abnormal esophageal motility in primary Sjögren's syndrome. J Rheumatol 3:63–69, 1976Google Scholar
  5. 5.
    Doig JA, Whaley K, Dick WC, Nuki G, Williamson J, Buchanan WW: Otolaryngological aspects of Sjögren's syndrome. Br Med J 4:460–463, 1971Google Scholar
  6. 6.
    Godtfredsen E: Relation between keratoconjunctivitis sicca (Sjögren's disease), dysphagia sideropenica (Plummer-Vinson syndrome), and ariboflavinosis. Trans Ophthmol Soc UK 67:175–183, 1948Google Scholar
  7. 7.
    Daniels TE: Labial salivary gland biopsi in Sjögren's syndrome. Arthritis Rheum 27:147–156, 1984Google Scholar
  8. 8.
    Greenspan JS, Daniels TE, Talal N, Sylvester RA: The histopathology of Sjögren's syndrome in labial salivary gland biopsies. Oral Surg 37:217–229, 1974Google Scholar
  9. 9.
    Kjellén G, Tibbling L: Manometric esophageal function, acid perfusion test, and symptomatology in a 55-year-old general population. Clin Physiol 1:405–415, 1981Google Scholar
  10. 10.
    Ask P, Edwall G, Tibbling L: Combined pH and pressure measurement devisce for oesophageal investigations. Med Biol Eng Comput 19:443–446, 1981Google Scholar
  11. 11.
    Ask P: Low-compliance pump for oesophageal manometry. Med Biol Eng Comput 16:732–738, 1978Google Scholar
  12. 12.
    Ask P, Öberg PÅ, Tibbling L: Frequency content of esophageal peristaltic pressure. Am J Physiol 236:E296-E300, 1979Google Scholar
  13. 13.
    Ask P, Carlsson P, Öberg PÅ, Pettersson H, Törngren P, Tibbling L: Feedback system for control of abdominal compression in oesophageal investigations. Med Biol Eng Comput 19:501–503, 1981Google Scholar
  14. 14.
    Bernstein LM, Baker LA: A clinical test for esophagitis. Gastroenterology 34:760–781, 1958Google Scholar
  15. 15.
    Ailken RCB: Measurement of feelings using the visual analog scale. Proc R Soc Med 62:989–993, 1969Google Scholar
  16. 16.
    Kjellén G, Svedberg JS: Oesophageal transit of a radionuclide solid bolus in normals. Clin Physiol 3:69–74, 1983Google Scholar
  17. 17.
    Benjamin SB, Richter JE, Cordova CM, Knuff TE, Castell DO: Prospective manometric evaluation with pharmacological provocation of patients with suspected esophageal dysfunction. Gastroenterology 84:893–901, 1983Google Scholar
  18. 18.
    Ask P, Tibbling L: Effect of time interval between swallows on esophageal peristalsis. Am J Physiol 238:G485-G490, 1980Google Scholar
  19. 19.
    Dodds WJ, Hogan WJ, Reid DP, Stewart ET, Andorfer RC: A comparison between primary esophageal peristalsis following wet and dry swallows. J Appl Physiol 35:851–857, 1973Google Scholar
  20. 20.
    Johnsson F, Joelsson B: The correlation between esophageal clearance and motility. The 4th World Congress on Bronchoesophagology, Stockholm, Sweden, 1983, p 31 (abstract)Google Scholar
  21. 21.
    Ekberg O, Nylander G: Cineradiography of the pharyngeal stage of deglutition in 150 individuals without dysphagia. Radiology 55:253–257, 1982Google Scholar
  22. 22.
    Thiséus S: Kirurgisk behandling av sideropen dysphagi. Studentlitteratur, Lund, Sweden, thesis 1971 (English summary)Google Scholar
  23. 23.
    Ekberg O: Cervical esophageal webs in patients with dysphagia. Clin Radiol 32:633–641, 1981Google Scholar
  24. 24.
    Buchanan WW, Cox AS, Harden RM: Gastric studies in Sjögren's syndrome. Gut 7:351–354, 1966Google Scholar
  25. 25.
    Similä S, Kokkonen J, Kaski M: Achalasia sicca—juvinile Sjögren's syndrome with achalasia and gastric hyposecretion. Eur J Pediatr 129:175–181, 1978Google Scholar
  26. 26.
    Dyer NH, Pridie RB: Incidence of hiatus hernia in asymptomatic subjects. Gut 9:696–699, 1968Google Scholar
  27. 27.
    Mandelstam P, Lieber A: A cineradiographic evaluation of the esophagus in normal adults. A study of 146 subjects ranging in age from 21 to 90 years. Gastroenterology 58:32–39, 1970Google Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • G. Kjellén
    • 1
  • S. G. Fransson
    • 1
  • F. Lindström
    • 1
  • H. Sökjer
    • 1
  • L. Tibbling
    • 1
  1. 1.Departments of Otolaryngology, Diagnostic Radiology, and RheumatologyUniversity HospitalLinköpingSweden

Personalised recommendations