Esophageal transit scintigraphy and structured questionnaire in patients with systemic sclerosis with endoscopically proven reflux esophagitis

Abstract

Esophageal complications are common in patients with systemic sclerosis (SSc). The relationship between gastroesophageal reflux (GER) symptoms and dysmotility was examined in endoscopically confirmed patients suspected of having reflux esophagitis. A total of 32 patients with limited and diffuse type SSc (lSSc, dSSc) were examined based on a structured questionnaire score (QS) of GER symptoms, retention fraction of esophageal scintigraphy at 90 s (R(90)) and gastric emptying time. The QS was significantly higher in the reflux esophagitis group than in the non-esophagitis group (5.4 +/- 3.5, 1.4 +/- 2.9, P = 0.003). When the non-esophagitis group was further divided into lSSc and dSSc groups, R(90) was higher in the reflux esophagitis group (31 +/- 18%) and the non-esophagitis group with dSSc (34 +/- 32%) than in the non-esophagitis group with lSSc (8 +/- 3%, P = 0.02). Both high R(90) >or= 15% and QS >or= 4 indicated reflux esophagitis. Conversely, both normal R(90) and QS indicated no reflux esophagitis. A combination of esophageal scintigraphy and structured questionnaire demonstrated different aspects of esophageal dysfunction, namely dysmotility and GER. Patients with high QS and dysmotility may be indicated for further evaluation including endoscopic examination and medical treatment.