title: Impaired gastric emptying in primary Sjogren's syndrome.
abstract: OBJECTIVE
  To investigate the prevalence of impaired gastric emptying (IGE) and its relation to autonomic nervous dysfunction (AD), functional bowel syndrome, and inflammatory and serological variables in patients with primary Sjögren's syndrome (pSS).
  
  
  METHODS
  Twenty-eight patients with pSS according to the American-European Consensus Criteria were included in the study. Gastric emptying was evaluated by the octanoate breath test from which half-time (t(half)) and lag-time (t(lag)) were determined and compared with the results from 50 healthy controls. Autonomic nervous function was evaluated by 5 objective autonomic reflex tests (ART) and by the Autonomic Symptom Profile (ASP) questionnaire evaluating AD symptoms. These results were compared with previously investigated healthy ART controls and population-based ASP controls. Patients were also assessed regarding symptoms of functional bowel syndrome.
  
  
  RESULTS
  The t(half) and the t(lag) were significantly prolonged in patients compared to controls. Forty-three percent of patients with pSS presented signs of IGE and 29% fulfilled the criteria for gastroparesis. Significant correlations were found between t(lag) and increased levels of IgG (p = 0.02) and erythrocyte sedimentation rate (ESR; p = 0.01). In addition, rheumatoid factor (RF) seropositives showed objective signs of IGE to a greater extent than RF seronegatives. No associations between IGE, ART variables, ASP variables, or gastrointestinal symptoms were found.
  
  
  CONCLUSIONS
  IGE was common in pSS. Associations with inflammatory and serological features of pSS could imply immunological mechanisms behind the IGE. Objective signs of IGE were not associated with objective signs or subjective symptoms of AD or functional bowel syndrome.
authors.affiliation: Department of Clinical Sciences, Division of Gastroenterology and Hepatology, Skåne University Hospital, Lund University, Malmö, Sweden. oskar.hammar@med.lu.se
authors.forename: Oskar
authors.initials: O
authors.lastname: Hammar
authors.forename: Bodil
authors.initials: B
authors.lastname: Ohlsson
authors.forename: Per
authors.initials: P
authors.lastname: Wollmer
authors.forename: Thomas
authors.initials: T
authors.lastname: Mandl
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D001944:Breath Tests; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012859:Sjogren's Syndrome / Q000150:complications* / Q000503:physiopathology; D011795:Surveys and Questionnaires