PRIMARY BILIARY-CIRRHOSIS, SICCA COMPLEX, AND DYSPHAGIA

We investigated symptoms suggestive of swallowing problems in patients with primary biliary cirrhosis, some of whom displayed features of si cca complex. A prospective study of 95 consecutive patients with prima ry biliary cirrhosis was conducted at a single teaching hospital using a questionnaire administered over the telephone. Some symptoms of sic ca complex (dry mouth and/or dry eyes) were found in 65 patients (68.4 %). Subjective xerostomia alone was present in 45 patients (47.4%). Th e questionnaire revealed an increase in incidence of dysphagia in xero stomia subjects, affecting 21 of 45 patients, compared with 6 of 50 no n-xerostomia patients. Multivariate logistic regression analysis showe d that confounding factors such as age, obesity, cigarette smoking, an d medications associated with a dry mouth could not explain these find ings. Twenty-eight patients complained of hoarseness, 23 of coughing, and 14 of wheezing, all of which were significantly more frequent than in the 50 patients without xerostomia. Heartburn affected 17 xerostom ia patients and 15 non-xerostomia patients, indicating no difference i n frequency between these two groups, even after age, obesity, cigaret te smoking, and medications associated with heartburn were considered in the multivariate analysis. Acid regurgitation, nausea, and vomiting were also similar in frequency between patients with and without xero stomia. Swallowing problems, manifested primarily as dysphagia, are co mmon in primary biliary cirrhosis patients who have subjective xerosto mia.