Abstract
On the basis of clinical and endoscopic examination of 31 patients with ankylosing spondylitis (AS) with clinical signs of esophageal lesions, we have found that in these patients erosive lesions of the esophagus occur much more often than in simple gastroesophageal reflux disease (GERD). Esophageal lesions in patients with AS are more severe than in simple GERD — severe erosive esophagitis (of C and D grade) is detected in 43.8 % of patients with erosive and ulcerative lesions of the esophagus against AS. Microscopic examination of biopsy material taken from esophageal mucosa suggests multifactorial mechanism of esophageal lesions in AS, including systemic and local immune inflammation, abnormal microvasculature, excessive proliferation of connective tissue, disseminated sclerotic processes in the wall of the esophagus, reduced number of esophageal glands.
Highlights
Ankylosing spondylitis (AS) is a systemic disease of the connective tissue, mainly affecting the joints and ligaments of the spine and may be related to pathological process of internal organs
Analysis of the endoscopic picture found that the erosive form of esophageal lesions in patients with AS occurs much more frequently than in the classical course of gastroesophageal reflux disease (GERD) (Table 1)
Higher prevalence of erosive form of esophageal lesions in AS patients showed existence in the mucosa of the esophagus background that leads to epithelial damage and generated by systemic autoimmune inflammatory process
Summary
Ankylosing spondylitis (AS) is a systemic disease of the connective tissue, mainly affecting the joints and ligaments of the spine and may be related to pathological process of internal organs. The diagnosis of GERD — primarily clinical, and a large number of patients does not exhibit endoscopic evidence of disease [4,5,6]. The main clinical symptom of GERD, is observed among patients with rheumatological diseases 1.6 times more often than in the population [7]. One of them is deformation of the cervical spine, with changed topography of the esophagus affecting its peristaltic function. Another symptom observed in patients with AS is visceral and diaphragmatic compression due to the strain in the thoracic and lumbar spine.
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