Sa1182 Quantifying Esophagogastric Junction (EGJ) Relaxation With a 3D-High-Resolution Manometry (HRM) Device: Comparison With Standard HRM and Among Novel Analysis Paradigms

Abstract

Systemic sclerosis (SSc) or scleroderma is an autoimmune illness which frequently involves the gastrointestinal apparatus. Patients affected by scleroderma have frequently lower LES pressure, ineffective esophageal motility (IEM), delayed gastric emptying (GE) and prolonged oro-cecal transit time (OCTT). Our aim was to assess prospectively the correlation between delayed OCTT and esophageal motility abnormalities in a cohort of SSc patients. We enrolled 50 (7M/43F; median age 57) consecutive SSc patients and 60 healthy volunteers (HVs; 12M/ 48F; median age 47). Both groups underwent 50g oral glucose breath test (GBT) to exclude small intestine bacterial overgrowth, 10g lactulose hydrogen and octanoic acid breath tests (LHBT and OBT) to measure OCTT [normal value = 105min] and GE [normal value = 146min], and manometry to evaluate esophageal motility patterns according to international criteria (Spechler and Castell). Median LES pressure and distal esophageal wave amplitude were lower in SSc patients compared to HVs (15 vs. 25 and 35 vs. 86 mmHg, P 180min, P<0.01). We showed that abnormalities of both esophageal and small intestine motility are frequent in SSc patients and that, when the small bowel is involved by the disease, in most cases also esophageal motility is altered. Delayed GE plays a limited role in prolonging OCTT. LHBT is a noninvasive, cheap, well-tolerated diagnostic tool that may be useful to estimate intestinal involvement and also to predict a higher risk of esophageal hypomotility in SSc patients.