Manometric assessment of impaired esophageal motor function in primary Sjogren's syndrome

Objective To evaluate by manometry the esophageal motility changes in patie nts with primary Sjogren's syndrome (SS). Methods Esophageal manometry was carried out in 25 (F/M: 22/3) primary SS p atients with systemic manifestations and in 42 control subjects. The primar y SS patients also completed a dysphagia scoring questionnaire and underwen t whole salivary flow measurements. Results As compared with the controls the primary SS patients exhibited a d ecreased lower esophageal sphincter (LES) pressure (p < 0.01) and a prolong ation of LES relaxations (p < 0.02). In the esophageal body (EB) a decrease d peristaltic velocity (p < 0.01), an increased duration of contractions (p < 0.01) and a higher occurrence of simultaneous waves (p < 0.01) M eve det ected. Since decreased peristaltic velocity was the most frequent motor abn ormality (11/25 cases), two groups of patients were formed for further anal ysis: patients with a decreased (group I, n = 11) and patients with a norma l (group II, it = 14) peristaltic velocity. The SS patients with a decrease d EB propagation velocity (<less than or equal to> 2.7 cm/s, group I) displ ayed more significantly decreased pressures (p < 0.01) and more prolonged r elaxation times (p < 0.05) in the LES, with higher rates of simultaneous co ntractions on dry swallows (p = 0.05) in the EB, as compared with those Mho had a normal peristaltic velocity (group II). Of the clinical parameters, the decreased EB peristaltic velocity was associated with a smaller whole s aliva production both ill the basal state and after stimulation. Furthermor e, this group of patients had a significantly higher liquid requirement for swallowing than those who had normal peristaltic velocities (p = 0.05). Conclusions Primary SS patients with systemic manifestations exhibit severa l esophageal motility abnormalities. In this study, a decreased EB peristal tic velocity was the most common manometric change, and showed an associati on with impaired saliva production and higher liquid requirement for swallo wing, but not Ic with the laboratory parameters or with the systemic manife stations of the disease.