GASTROINTESTINAL TRANSIT THROUGH ESOPHAGUS, STOMACH, SMALL AND LARGE-INTESTINE IN PATIENTS WITH PROGRESSIVE SYSTEMIC-SCLEROSIS

Liquid esophageal transit and gastric emptying, mouth-to-cecum transit , and whole gut transit of a solid-liquid meal were measured in 14 pat ients with PSS, 16 control subjects (esophageal transit), and 20 contr ol subjects (gastrointestinal transit), respectively, by using scintig raphic techniques, the hydrogen breath test, and stool markers. In pat ients with PSS, the glucose hydrogen breath test for detection of smal l intestinal overgrowth was performed and various gastrointestinal sym ptoms were determined. Esophageal transit and gastric emptying were si gnificantly prolonged in PSS patients with 11 of 14 PSS patients (79%) disclosing delayed esophageal transit and eight of 14 PSS patients (5 7%) disclosing delayed gastric emptying. All PSS patients with prolong ed gastric emptying also had delayed esophageal transit and there was a significant positive correlation between esophageal transit and gast ric emptying (r = 0.696, P < 0.01). No significant differences between PSS patients and controls were detected concerning mouth-to-cecum tra nsit and whole gut transit, but abnormally delayed mouth-to-cecum tran sit was found in four of 10 PSS patients (40%) and abnormally prolonge d whole gut transit was detected in three of 13 PSS patients (23%). Sm all bacterial overgrowth was diagnosed in three of 14 PSS patients (21 %). Delayed esophageal transit and gastric emptying were associated wi th dysphagia, retrosternal pain, and epigastric fullness, while prolon ged whole gut transit was associated with constipation. It is conclude d that delayed gastric emptying is frequently associated with esophage al transit disorders in PSS patients and may be one important factor f or the development of gastroesophageal reflux disease in these patient s.