MANOMETRY OF THE UPPER INTESTINAL-TRACT IN PATIENTS WITH SYSTEMIC-SCLEROSIS - A PROSPECTIVE-STUDY

Objective. To assess both the prevalence and the characteristics of mo tor disorders of the small bowel in patients with systemic sclerosis ( SSc) and to investigate for an association between clinical manifestat ions in the upper intestinal tract, capillaroscopic features, esophage al motor impairment, and manometric evidence of motor disturbances. Me thods. Fasting and postprandial motor activity of the upper intestinal tract was studied in 17 consecutive patients with SSc (6 with and 11 without clinical manifestations of small bo,vel involvement) and 17 ag e-and sex-matched healthy control subjects. Results. The prevalence of manometric evidence of intestinal involvement was as high as 88% in t he SSc patients; normal motor activity was present in only 2 patients. The median values for duodenal and jejunal interdigestive phase III m igrating motor complex duration, amplitude, and velocity and the postp randial motility index were therefore lower in SSc patients compared w ith controls. Our manometric findings indicated that there are both ne uropathic and myopathic stages of upper intestinal tract dysfunction i n SSc, Furthermore, no association could be found between the severity of the intestinal manometric abnormalities and clinical presentation, SSc subsets, disease score, capillaroscopic findings, or esophageal m anometric impairment. Conclusion. We suggest that manometry of the upp er intestinal tract may be useful in SSc patients with clinical manife stations in the small bowel (i.e., malabsorption syndrome or pseudoobs truction) in that it can be used to accurately evaluate both the natur e and the severity of motor disturbances. Furthermore, this procedure can be used to assist in the selection of patients who may require oct reotide therapy.