THE EXTENT AND PATTERN OF GASTROESOPHAGEAL REFLUX IN PATIENTS WITH SCLERODERMA ESOPHAGUS - THE EFFECT OF LOW-DOSE OMEPRAZOLE

Ambulatory 24-hour oesophageal pH studies were obtained from 11 patien ts with scleroderma who expressed either dysphagia (n = 6) or heartbur n (n = 5) as their predominant oesophageal symptom. No significant dif ferences were found in the extent of pattern of reflux between these t wo groups. The pH data of both scleroderma groups were combined and co mpared to an age- and sex-matched group of control subjects (n = 11). The reflux demonstrated by scleroderma patients was significantly grea ter than the control group in every category (P < 0.01). The percentag e of time the pH was < 4.0 was not significantly different (P > 0.05) upright (29.9 +/- 19.8 %) vs. supine (44.2 +/- 28.5 %) in patients wit h scleroderma. Eight scleroderma patients underwent repeat pH studies while taking low-dose omeprazole (20 mg daily) and reflux was reduced significantly (P < 0.01) in all patients. The authors believe that 24- hour ambulatory oesophageal pH-monitoring should be routinely conducte d in scleroderma patients to provide quantitative reflux data, even wh en heartburn is not expressed as a symptom. Omeprazole, 20 mg daily, p rovides adequate protection from the H+ component of the refluxate.