title: Gastrointestinal motility disorder assessment in systemic sclerosis.
abstract: OBJECTIVE
  SSc is a clinically heterogeneous and generalized disease, characterized by thickness of the connective tissue of the skin and internal organs, such as the digestive tract, impairing gastrointestinal (GI) motility. Our aim is to evaluate retrospectively abnormalities of oesophageal motility, gastric emptying, oro-cecal transit time (OCTT) and small intestine bacterial overgrowth (SIBO) in a large cohort of SSc patients.
  
  
  METHODS
  Ninety-nine SSc patients were included in the study. Forty-two patients underwent oesophageal conventional manometry, 45 performed a [(13)C]octanoic acid breath test to measure gastric emptying time and all 99 patients performed a lactulose breath test in order to evaluate OCTT and SIBO. Data were compared with healthy controls.
  
  
  RESULTS
  In SSc patients, median lower oesophageal sphincter (LOS) pressure [14 mmHg (25th-75th; 8-19) vs 24 mmHg (19-28); P < 0.01] and median wave amplitude [30 mmHg (16-70) vs 72 mmHg (48-96); P < 0.01] were lower than in controls. Oesophageal involvement, defined as reduced LOS pressure and ineffective oesophageal motility pattern, was encountered in 70% of SSc patients. A delayed gastric emptying time was present in 38% of SSc patients: mean t½ was 141 ± 79 min vs 90 ± 40 min of controls (P < 0.01). Also, OCTT was significantly delayed in SSc: median OCTT was 160 min (25th-75th; 135-180) vs 105 min (25th-75th; 90-135) of controls (P < 0.01). SIBO was observed in 46% of SSc compared with 5% of controls (P < 0.01).
  
  
  CONCLUSIONS
  GI involvement is very frequent in SSc patients. Oesophagus and small bowel are more frequently impaired, whereas delayed gastric emptying is less common.
authors: Gastroenterology Unit, University of Padua, Padua, Italy.
authors: Edoardo
authors: E
authors: Savarino
authors: Federico
authors: F
authors: Mei
authors: Andrea
authors: A
authors: Parodi
authors: Massimo
authors: M
authors: Ghio
authors: Manuele
authors: M
authors: Furnari
authors: Adelina
authors: A
authors: Gentile
authors: Michela
authors: M
authors: Berdini
authors: Antonio
authors: A
authors: Di Sario
authors: Emanuele
authors: E
authors: Bendia
authors: Patrizia
authors: P
authors: Bonazzi
authors: Emidio
authors: E
authors: Scarpellini
authors: Lucrezia
authors: L
authors: Laterza
authors: Vincenzo
authors: V
authors: Savarino
authors: Antonio
authors: A
authors: Gasbarrini
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology; D005769:Gastrointestinal Motility / Q000502:physiology*; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications* / Q000382:microbiology / Q000503:physiopathology
keywords: 13C-octanoate breath test; gastrointestinal motility; lactulose breath test; oesophageal manometry; scleroderma; systemic sclerosis