Esophageal function and Sjögren's syndrome.
The frequency and characteristics of esophageal dysmotility in Sjögren's syndrome (SS) are as controversial as their related symptoms. We evaluated esophageal function and gastroesophageal reflux (GER) in 21 SS patients using manometry and 24-hr esophageal pH monitoring. All patients complained of xerostomia, 33% of dysphagia, and 62% of heartburn. Compared to controls, the mean percentage abdominal length of their lower esophageal sphincters (LES) and resting LES pressures were significantly lower, with no difference in primary esophageal peristalsis. Tertiary waves without swallowing were detected in 29% of them and pathological GER in 67%. Symptoms, esophageal motor abnormalities, and reflux features were similar in primary and secondary SS. ANOVA indicated that dysphagia was unrelated to the esophageal impairments and GER analysis results, while heartburn was significantly associated with GER severity. Esophageal acid-exposure time was significantly longer in SS patients with distal tertiary waves, while proximal esophagus wave velocity was significantly lower. While SS patients have nonspecific esophageal motility disorders and frequently GER disease, early and accurate diagnosis of GER is essential to identify SS patients at risk for acidic reflux, especially because the acid-clearance capacity of the esophagus is already diminished by the lack of saliva.
Volter
Françoise
F
Laboratoire de Physiologie Digestive and Service de Medecine Interne, AP-HP, Hôpital Jean-Verdier, 93143 Bondy Cedex, France. francoise.volter@cch.ap-hop-paris.fr
Fain
Olivier
O
Mathieu
Emmanuel
E
Thomas
Michel
M
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003680:Deglutition Disorders / Q000209:etiology; D004947:Esophagus / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D006356:Heartburn / Q000209:etiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010528:Peristalsis; D012859:Sjogren's Syndrome / Q000150:complications / Q000503:physiopathology*; D014987:Xerostomia / Q000209:etiology