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

  • Dustin A. Carlson
  • Monique Hinchcliff
  • John E. Pandolfino
Scleroderma (J Varga, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Scleroderma

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.

Keywords

Systemic sclerosis GERD Esophageal reflux monitoring Manometry Impedance 

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

Notes

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).

Compliance with Ethics Guidelines

Conflict of Interest

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.

Human and Animal Rights and Informed Consent

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

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Dustin A. Carlson
    • 1
  • Monique Hinchcliff
    • 2
  • John E. Pandolfino
    • 1
  1. 1.Feinberg School of Medicine, Department of Medicine, Division of Gastroenterology and HepatologyNorthwestern UniversityChicagoUSA
  2. 2.Feinberg School of Medicine, Department of Medicine, Division of RheumatologyNorthwestern UniversityChicagoUSA

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