| Gastrointestinal
Involvement (Main Menu) |
|
| Esophageal
(Throat) Involvement |
| These symptoms may occur
in systemic scleroderma but not in localized
scleroderma, such as Linear and Morphea. See Types
of Scleroderma. This page was written by Shelley
Ensz, and has not yet been medically edited. Scleroderma
(SD) affects everyone differently. Just because something is
listed here does not mean an individual patient will ever experience
it. See Disclaimer. |
|
| Air Esophagogram |
| Air in the esophagus is a very
unusual x-ray finding, and particularly when its not associated
with a fluid level indicative of a stricture, should strongly
suggest Scleroderma. "This radiological sign, although
rare, should suggest Scleroderma and may be particularly useful
in patients with "systemic sclerosis sine scleroderma." (1) |
| Barrett's Esophagus |
| Barrett's
esophagus. The past year has brought many advances in
the epidemiology and endoscopic treatment of those with Barrett's
esophagus. PubMed. Curr Opin Gastroenterol. 2006 Jul;22(4):406-11. |
| New techniques improve imaging quality, not diagnosis of Barrett's esophagus. When the enhancement techniques were compared with regular WLE images, the observers clearly preferred the enhancement techniques, which scored higher in terms of overall image quality, the quality of mucosal imaging, and the quality of vascular imaging. EurekAlert! 03/11/08. |
| Camera in a pill offers cheaper, easier window on your insides. This scanning device rather than an endoscope is cheap because it's so small it doesn't require anesthesia and sedation, UWNews.org. 01/24/08. |
| New Treatment Offered For Damaged Esophagus. Interventional gastroenterologists at Rush now offer a noninvasive ablation (removal of harmful tissue) procedure to treat Barrett's esophagus, a precancerous condition in which a thin layer of tissue lining the lower esophagus is damaged due to chronic acid reflux. Medical News Today. 09/14/07. |
| Investigators Uncover Intriguing Clues To Why Persistent Acid Reflux Sometimes Turns Into Cancer. "The research supports why it is important to prevent reflux, because the more reflux you have and the longer you have it, the more it might predispose you to getting Barrett's esophagus. So you want to suppress that reflux," said Dr. Rhonda Souza.Medical News Today. 08/13/07. (Also see: GERD) |
| Heartburn-related
Cancer is curable. The clinical picture of esophageal
cancer is changing, and so is the traditionally bleak prognosis
for the disease, new research suggests. WebMD 04/17/06. |
| Photodynamic
therapy is an alternative to removal of Esophagus. Over
time, untreated GERD damages the lining of the esophagus
and could result in Barrett’s esophagus. Photodynamic
therapy could become the first line of treatment, or a more
widely used alternative to esophagectomy. University of
Kentucky News. 04/05/06. |
| HSR
Pioneers Procedure. The Hospital of Saint Raphael (HSR)
became one of the first medical centers in New England to
successfully perform Minimally Invasive Esophagectomy (MIE),
which provides for better patient outcomes and shorter recovery
times for esophageal cancer, Barrett's esophagus, scleroderma
and achalasia. Business New Haven. 12/26/05. |
| Prevalence
of Barrett's Esophagus in Systemic Sclerosis. We found
a prevalence of 12.5% of Barrett’s esophagus. This seems
to be quite similar to the prevalence found in patients with
chronic reflux without systemic sclerosis. We did not find
any patients with adenocarcinoma but 3/13 (23%) had dysplasic
metaplasia. J. Wipff. FRI0061 EULAR 2005. |
| Carol
Langenfeld: Diffuse Scleroderma (Carol is co-author
of the book Living
Better : Every Patient's Guide to Living with Illness) People
tell me that I have earned my credentials as a "certified
patient" the hard way... |
| Don
Alfera: CREST, Pulmonary Fibrosis and Sjögren's I
entitled this "My Time So Far" since this has been
a journey unlike any that I could have ever tried to imagine
in my life... |
| Jerri:
CREST Syndrome I was twenty-one years of age when
I first noticed that my fingers, toes and lips were turning
colors... |
| Sharon:
CREST with Limited Scleroderma, Sjögren's and Pulmonary
Hypertension (Australia) Day by day I discover another
food I cannot eat... |
| Correlation with Lung
Disease |
| Clinical features of scleroderma patients with contracture of phalanges (CP). Our study suggested that the presence of CP may be a marker of oesophageal involvement, pulmonary fibrosis and heart involvement. PubMed Clin Rheumatol. 2007 Aug;26(8):1275-7. (Also see: Joint Contractures, Pulmonary fibrosis, Cardiac Involvement) |
| Clinical features of scleroderma patients with contracture of
phalanges (CP). The study suggested that the presence
of CP may be a marker of oesophageal involvement, pulmonary
fibrosis and heart involvement. PubMed. Clin Rheumatol.
2006 Dec 15. (Also see: Muscle
and Joint Involvement, Pulmonary
Fibrosis, and Cardiac
Involvement) |
| Esophageal
Involvement is Correlated with Interstitial Lung Involvement
(ILD) in Systemic Sclerosis (SSc) Patients. In our study,
100% of 25 unselected SSc patients showed some degree of
GE disease by manometry. A significant correlation was shown
between manometric parameters and the reduction of total
lung capacity and DLCO. E. Vesprini. FRI0104 EULAR 2005.
(Also see: What is
Scleroderma?, Aspiration
Pneumonia, and Pulmonary
Fibrosis) |
| Dysphonia (Hoarseness,
Loss of Voice) |
| Achalasia
in circumscribed scleroderma. The association of achalasia
and circumscribed scleroderma could possibly be based on
common autoimmune mechanisms and an analogous pathogenesis
with resulting fibrosis. PubMed. Dtsch Med Wochenschr.
2006 Aug;131(33):1799-802. |
| Evaluation
of Dysphonia in Patients with Scleroderma with Videolaryngostroboscopy. Scleroderma
affects the larynx and causes the dysphonia. This could be
due to the over production of the extracelular matrix and
the oedematous stage of the disease. There is still a need
of a large series to show the types of the laryngeal pathology. M.
Tezer. FRI0326 EULAR 2004. |
| Dysphonia (Hoarseness,
Loss of Voice) Personal Stories |
| Leeben:
Limited Scleroderma and CREST I had a traumatic forty-five-minute
intubation and landed up in the ICU with problems breathing
and paralyzed vocal cords. It has been the most devastating
thing for me, since the loss of of my voice has caused social
isolation and dependence... |
| Esophageal Diseases |
| A case-control study of the pathology of esophageal disease
in systemic sclerosis (scleroderma). The loss of circular
and longitudinal smooth muscle in the distal scleroderma
oesophagus may represent loss of normal neural function followed
by secondary tissue atrophy, or may be a primary smooth muscle
lesion. PubMed. Gut. 2006 Dec;55(12):1697-703. |
| Open
Esophagus on HR-CT Scan is Predictive for SSc. An open
esophagus on a HR-CT scan, performed for whatever reason
has a high positive predictive value for SSc and should prompt
further examinations to confirm or exclude this diagnosis. M.
C. Vonk. SAT0260 EULAR 2006. |
| Esophageal
manometry in early and definite systemic sclerosis. The
correlation between LES (lower esophageal sphincter) abnormalities
and FVC (forced vital capacity) suggests a possible causal
relationship between these disease manifestations. PubMed.
Clin Rheumatol. 2004 Dec 9. |
| Radionuclide
Gastroesophageal Motor Studies. The role of radionuclide
gastroesophageal motor studies is clearly identified in the
various steps of patients' management, from the initial diagnostic
approach to functional characterization to postoperative
follow-up or monitoring of medical therapy. PubMed. J
Nucl Med. 2004 Jun;45(6):1004-1028. |
| Esophageal
Dysfunction in Patients with Definite and Early Systemic
Sclerosis. Esophageal manometry can detect abnormalities
in a sizeable proportion of patients with early SSc not fulfilling
the ACR criteria, including asymptomatic patients. The correlation
between lower esophageal sphincter abnormalities and Forced
Vital Capacity suggests a possible causal relationship between
these disease manifestations. P. Airo'. FRI0285 EULAR
2004. (Also see: Pulmonary
Involvement) |
| The
diagnostic value of oesophageal transit scintigraphy for
evaluating the severity of oesophageal complications in systemic
sclerosis. An oesophageal scan can detect both slight
and severe types of oesophageal dysfunction, and can be used
as a quantitative method that reflects functional abnormality
in SSc. PubMed. Nucl Med Commun. 2004 Apr;25(4):375-381. |
| Bacteria
live in the esophagus! The esophagus isn't merely a tube
for food traveling from the mouth to the stomach, it also
provides an environment for bacteria to live, according to
a new study by NYU School of Medicine scientists that overturns
the general belief that the esophagus is free of bacteria. EurekAlert
03/05/04. (Also see: Heartburn) |
| Chest
Pain, Chronic Many different types of problems can cause
discomfort, shortness of breath, pain with swallowing, and
many other symptoms in the chest area. This chart may help
you pinpoint your problem as you confirm your symptoms. familydoctor.org |
| Digestive
System Diseases Karolinska Institute library |
| Esophageal Motility
Disorders |
| Esophageal
disease in scleroderma. Motility studies in patients
with scleroderma show reduced-amplitude or absent peristaltic
contractions in the distal two-thirds of the esophagus and
normal or decreased lower esophageal sphincter pressure. PubMed.
J Clin Gastroenterol. 2006 Oct;40(9):769-75. |
| Initial
experience with magnetic resonance fluoroscopy in the evaluation
of oesophageal motility disorders. Comparison with manometry
and barium fluoroscopy. Our work demonstrates that MR
fluoroscopic examination in subject affected by oesophageal
motility disorders is feasible and can properly depict motility
and morphology alterations, achieving correct diagnosis in
the majority of cases. PubMed. Eur Radiol. 2006 Apr 26. |
| Metoclopramide
response in patients with early diffuse systemic sclerosis.
Effects on esophageal motility abnormalities. The results
of our study show that metoclopramide may improve LES (lower
esophageal sphincter) pressures in patients with early and
late dSS. Because metoclopramide can be used orally, it may
mitigate both dysphagia and heartburn. PubMed. Clin Exp
Rheumatol. 2005 Sep-Oct;23(5):685-8. (Also see: Dysphagia and Heartburn) |
| Radiographic
evaluation of esophageal function. Performing studies
of the highest technical quality yields the most definitive
results. Motility disorders such as achalasia and scleroderma
have specific radiographic findings. PubMed. Gastrointest
Endosc Clin N Am. 2005 Apr;15(2):231-42. |
| Esophageal
dysmotility in scleroderma patients with different disease
forms and ANA patterns: a scintigraphic study in 100 cases. The
scintigraphy confirms to be a useful and non invasive diagnostic
method; moreover it permits to quantify the severity of the
esophageal dysmotility by analyzing both global and segmental
function. PubMed. Reumatismo. 2003;55(2):86-92. |
| Interstitial lung disease (ILD) in Systemic Sclerosis (SSc) and its Association
with Esophageal Motility Disturbance. Our single center
study suggests a positive correlation of digital infarct
with ILD in diffuse SSc and a positive correlation of esophageal
motility disturbance and ILD; but there was no effect on
severity of ILD in SSc patients and no difference in severity
of ILD in diffuse and limited cutaneous SSc. R. Gupta.
AB0333 EULAR 2003 (Also see: Pulmonary
Involvement) |
| Esophageal Motility Stories |
| Annette
G: MCTD, Systemic Scleroderma, Chronic Kidney Disease, CFS,
Fibromyalgia, Trigeminal Neuralgia, TMJ People think
that because I am a nurse I have all the answers. Well guess
what? I don't... |
| Esophageal Stricture |
| Esophageal
Stricture is an abnormal narrowing of the esophagus. |
| See Medical
Tests: Esophageal Dilation |
| Radiologic
diagnosis of benign esophageal strictures: a pattern approach. When
esophageal strictures are detected at barium examination,
the underlying cause can often be determined with a pattern
approach that takes into account the clinical history, the
appearance and location of the strictures, and the presence
of other associated radiographic findings.PubMed. Radiographics.
2003 Jul-Aug;23(4):897-909. |
| Esophageal Stricture Personal
Stories |
| Judy
R. Thompson Devlin: Diffuse Scleroderma with CREST He
said 1 in 200 people get a disease in their lifetime, and
that scleroderma was like having 20-30 diseases at once... |
| Lorrie:
Limited Scleroderma/CREST At first I thought, "Oh
my goodness! I am going to die." But my doctor assured
me that I could very likely live to be an old woman... |
| Lynsey:
Daughter of Patient with Scleroderma and Lupus My
mother has had all but four fingers amputated, all of her
toes on her left foot and her right leg up to her knee has
been amputated... |
| Esophageal Ulcer |
| Esophageal Ulcer is an open sore
in the esophagus. |
| Frequency
and Characteristics of Esophageal Lesions in Systemic Sclerosis
(SSc) According to the Data of Endoscopy. Endoscopic
signs of esophageal involvement were found in the majority
of patients with SSc, including serious lesions (erosions
and ulcers). A. E. Karateev. FRI0362 EULAR 2006. |
| A
case-controlled study of the pathology of esophageal disease
in systemic sclerosis (scleroderma). The loss of circular
and longitudinal smooth muscle in the distal scleroderma
esophagus may represent loss of normal neural function followed
by secondary tissue atrophy, or may be a primary smooth muscle
lesion. PubMed. Gut. 2006 Mar 9. |
| Gastric MALT Lymphoma |
| Systemic
sclerosis and gastric MALT lymphoma. MALT (mucosa-associated
lymphoid tissue) lymphomas are usually confined to the gastric
wall. Gastric MALT lymphomas have a well-established association
with H. pylori infection. Eradication of H. pylori is the
mainstay of treatment. PubMed. Joint Bone Spine. 2005
Jun 30. (Also see: Scleroderma
and Cancer) |
| Reflux (Heartburn) |
| Reflux (heartburn) occurs when
acid from the stomach backs up into the esophagus (throat). See Reflux
(Heartburn) by ISN. |
| Hoarseness:Reflux (heartburn)
is a frequent cause of dysphonia (hoarseness
or loss of voice) in scleroderma. |
| Esophageal
Involvement in Scleroderma: Gastroesophageal Reflux, the
Common Problem. Esophageal involvement is frequent in
SSc patients. Appropriate treatment of esophageal involvement
ameliorates symptoms and prevents complications. PubMed.
Semin Arthritis Rheum. 2006 Oct 10. (Also see: Reflux,
Heartburn, GERD) |
| A
Role of Helicobacter Pylori Infection in Gastroesophageal
Reflux Disease (GERD) in Patients with Systemic Sclerosis
(SSc). GERD is the most common gastrointestinal tract
disease in SSc. H.pylori infection might play an important
role in its severity. H. Kuno. AB0279 EULAR 2006. (Also
see: GERD) |
| Laparoscopic
fundoplication in patients with an aperistaltic esophagus
and gastroesophageal reflux. Patients with troublesome
reflux and an aperistaltic esophagus can be effectively treated
by laparoscopic fundoplication. An acceptable outcome will
be achieved in the majority of patients. PubMed. Dis Esophagus.
2006;19(2):94-8. |
| References |
| (1) Air esophagogram and intestinal
pseudoocclusion in a patient with scleroderma. J Rheumatol
1991;18: 897-899; Kraus A, Alarcón-Segovia D, Huddinge
University Hospital, Sweden |
