title: Loss of Peristaltic Reserve, Determined by Multiple Rapid Swallows, Is the Most Frequent Esophageal Motility Abnormality in Patients With Systemic Sclerosis.
abstract: We assessed peristaltic reserve using multiple rapid swallows (MRS) during esophageal high-resolution manometry (HRM) of 111 patients with systemic sclerosis (89 women; ages, 42-64 y). We performed a retrospective analysis of HRM studies that included MRS in patients with systemic sclerosis, performed at 2 tertiary referral centers, and compared data with those from 18 healthy volunteers (controls). HRM findings were analyzed according to the Chicago Classification to provide an esophageal motility diagnosis. Response to MRS was evaluated for the presence of contraction and for augmentation, defined as the distal contractile integral after MRS greater than the median distal contractile integral of 10 supine swallows. Esophageal motility diagnoses included 41% with absent contractility, 31% with normal motility, 23% with ineffective esophageal motility, and 5% that met the criteria for other esophageal motility disorders. Contraction (37%) and peristaltic augmentation (18%) after MRS were observed less frequently in patients with systemic sclerosis than in controls (83% and 100%, respectively). Impaired peristaltic reserve, as assessed with MRS during HRM, is therefore the most common esophageal motility finding among patients with systemic sclerosis.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Dustin A
authors.initials: DA
authors.lastname: Carlson
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Crowell
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Kimmel
authors.affiliation: Division of Gastroenterology and Hepatology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Amit
authors.initials: A
authors.lastname: Patel
authors.affiliation: Division of Gastroenterology and Hepatology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: C Prakash
authors.initials: CP
authors.lastname: Gyawali
authors.affiliation: Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Monique
authors.initials: M
authors.lastname: Hinchcliff
authors.affiliation: Division of Rheumatology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: W Leroy
authors.initials: WL
authors.lastname: Griffing
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: John E
authors.initials: JE
authors.lastname: Pandolfino
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona. Electronic address: vela.marcelo@mayo.edu.
authors.forename: Marcelo F
authors.initials: MF
authors.lastname: Vela
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D015154:Esophageal Motility Disorders / Q000453:epidemiology* / Q000473:pathology*; D004947:Esophagus / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications*; D062606:Tertiary Care Centers
keywords: Esophageal Motility; High-Resolution Manometry; Systemic Sclerosis