Internal medicine

Pathology

Inoculation

Mixed connective tissue disease

GERD

Esophagus

Disease

Gastroenterology

Surgery

Esophageal spasm

Dysphagia

High resolution manometry

Esophageal Disorder

Esophagitis

Achalasia

Scleroderma (fungus)

Esophageal disease

Reflux

Esophageal motility disorder

Medicine

Annals of Gastroenterology

Systemic sclerosis (SSc) is a multisystemic autoimmune connective tissue disorder; in the gastrointestinal tract, the esophagus is the most commonly affected organ.Symptoms of esophageal disease are due to gastroesophageal reflux disease (GERD) and esophageal motor dysfunction.Since the development of high-resolution manometry (HRM), this method has been preferred for the study of SSc patients with esophageal involvement.Using HRM, classic scleroderma esophagus, defined as absent or ineffective peristalsis of the distal esophagus in combination with a hypotensive lower esophageal sphincter, was found in as many as 55% of SSc patients.Endoscopy is the appropriate test for evaluating dysphagia and identifying evidence and possible complications of GERD.In the therapeutic area, treatment ranges from general supportive measures to the administration of drugs such as proton pump inhibitors and/or prokinetics.However, as many SSc patients do not respond to existing therapies, there is an urgent need for new therapeutic modalities.Buspirone, a 5-hydroxytryptamine 1A receptor agonist, could be a putative therapeutic option, as it was found to exert a significant beneficial effect in SSc patients with esophageal involvement.This review summarizes our knowledge concerning the evaluation and management of esophageal manifestations in SSc patients, including emerging therapeutic modalities.

Evaluation and management of esophageal manifestations in systemic sclerosis