ESOPHAGEAL DYSFUNCTION DOES NOT ALWAYS WORSEN IN SYSTEMIC-SCLEROSIS

Using the manometric method, we studied the progression of esophageal involvement in 17 women with a diagnosis of systemic sclerosis (SSc) a nd compared the results with those obtained for 14 healthy women. The manometric examination of SSc patients was performed twice, with an in terval of 9 to 111 months (median, 40 months). All patients had perist altic contractions in the proximal esophagus. Eight had peristaltic co ntractions, and 9 had no contraction in the middle and distal esophagu s. The lower esophageal sphincter pressure and the amplitude of contra ctions in the esophageal body were lower in SSc patients than in contr ols. The duration of contractions was the same in SSc patients and con trols. The velocity of peristaltic contractions did not differ between patients and controls in the distal esophagus, but was higher in SSc patients in the proximal esophagus. In 16 patients, no difference in l ower esophageal sphincter (LES) pressure, esophageal contraction ampli tude, duration, and velocity was observed between the first and second evaluation. In one patient, the distal esophageal contractions change d from peristaltic to completely absent, and the lower esophageal sphi ncter pressure changed from 20.2 mm Hg to 5.1 mm Hg. The results sugge st that the esophageal involvement of SSc patients was not progressive in all cases.