Outcome of small-bowel motor impairment in systemic sclerosis--a prospective manometric 5-yr follow-up.
OBJECTIVE
To assess the 5-yr course of small-bowel motor disorders, using manometry in patients with systemic sclerosis (SSc), and to investigate for an association between small-bowel motor dysfunction outcome and other clinical manifestations of SSc.


METHODS
Fasting and post-prandial motor activity of the small-bowel was systematically assessed in eight consecutive patients with SSc, using 24 h manometry: initially and at 5-yr follow-up.


RESULTS
At 5-yr follow-up, the eight SSc patients (100%) exhibited deterioration of small-bowel motor activity on manometry as follows: (1) more severe abnormalities of migrating motor complex phase III during the fasting period; (2) decreased median duodenal and duodeno-jejunal index during the post-prandial period; and (3) more frequent alterations of small-bowel motor activity in response to octreotide infusion. Furthermore, an association could be found between the deterioration of small-bowel motor function and pitting scars' onset.


CONCLUSIONS
Our study underscores the rapid deterioration of small-bowel motor impairment in SSc patients (100%). It also highlights the usefulness of small-bowel manometry in symptomatic SSc patients in objectively defining both the characteristics and degree of motor impairment, which may influence the choice of medical treatment in patients, particularly octreotide therapy.
Marie
I
I
Department of Internal Medicine, Rouen University Hospital, 76031 Rouen Cedex, France. isabelle.marie@chu-rouen.fr
Ducrotté
P
P
Denis
P
P
Hellot
M-F
MF
Levesque
H
H
D000328:Adult; D000368:Aged; D018450:Disease Progression; D005215:Fasting; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents; D005769:Gastrointestinal Motility; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology* / Q000503:physiopathology; D007421:Intestine, Small / Q000503:physiopathology*; D008365:Manometry; D008875:Middle Aged; D015282:Octreotide; D019518:Postprandial Period; D011379:Prognosis; D011446:Prospective Studies; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology
D005765:Gastrointestinal Agents; D015282:Octreotide