Jp. Shoenut et al., THE EXTENT AND PATTERN OF GASTROESOPHAGEAL REFLUX IN PATIENTS WITH SCLERODERMA ESOPHAGUS - THE EFFECT OF LOW-DOSE OMEPRAZOLE, Alimentary pharmacology & therapeutics, 7(5), 1993, pp. 509-513
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.