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Esophageal Involvement and Determinants of Perception of Esophageal Symptoms Among South Koreans With Systemic Sclerosis

Journal of Neurogastroenterology and Motility 2020년 26권 4호 p.477 ~ 485
이준성, 김현숙, Moon Jung-Rock, Ryu Tom, 홍수진, Cho Young-Sin, 박준석, 이태희,
소속 상세정보
이준성 ( Lee Joon-Seong ) - Soonchunhyang University College of Medicine Institute for Digestive Research
김현숙 ( Kim Hyun-Sook ) - Soonchunhyang University College of Medicine Department of Internal Medicine
 ( Moon Jung-Rock ) - Soonchunhyang University College of Medicine Institute for Digestive Research
 ( Ryu Tom ) - Soonchunhyang University College of Medicine Institute for Digestive Research
홍수진 ( Hong Su-Jin ) - Soonchunhyang University College of Medicine Department of Internal Medicine
 ( Cho Young-Sin ) - Soonchunhyang University Cheonan Hospital Department of Internal Medicine
박준석 ( Park Jun-Seok ) - Soonchunhyang University College of Medicine Institute for Digestive Research
이태희 ( Lee Tae-Hee ) - Soonchunhyang University College of Medicine Institute for Digestive Research

Abstract


Background/Aims: Our study aims to characterize esophageal motor function; evaluate the relationships among esophagogastroduodenoscopy (EGD), high-resolution manometry (HRM), and 24-hour esophageal multichannel intraluminal impedance monitoring combined with pH-metry (MII-pH); and elucidate the determinants of esophageal symptom perception in South Koreans with systemic sclerosis (SSc).

Methods: We reviewed prospectively collected HRM (n = 46), EGD (n = 41), and MII-pH (n = 37) data from 46 consecutive patients with SSc (42 females; mean age 50.1 years) who underwent esophageal tests between June 2013 and September 2018.

Results: The most common HRM diagnosis was normal (39.1%), followed by ineffective esophageal motility (23.9%) and absent contractility (21.7%). Erosive esophagitis was observed in 12.2% of total SSc patients, with a higher frequency in patients with absent contractility than those with normal motility (44.5% vs 0.0%, P = 0.01). Pathologic acid exposure was observed in 6 patients (20.0%) and positive symptom association in 18 patients (60.0%) in MII-pH tests of symptomatic patients. The proportion of SSc patients with esophageal symptoms not explained by reflux or mucosal or motor esophageal abnormalities was 33.0%.

Conclusions: Esophageal involvement among South Koreans with SSc was characterized by heterogeneous motility patterns, with a higher prevalence of normal motility and lower prevalence of erosive esophagitis. Reflux hypersensitivity or functional heartburn might be partly attributed to the perception of esophageal symptoms in SSc patients who have neither gastroesophageal reflux disease nor esophageal dysmotility.

키워드

Diagnosis; Esophageal motility disorders; Esophagus; Manometry; Scleroderma

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