Gastroesophageal Reflux Disease-Related Disorders of Systemic Sclerosis Based on the Analysis of 66 Patients

Digestion. 2018;98(4):201-208. doi: 10.1159/000489848. Epub 2018 Jul 25.

Abstract

Background/aims: Gastroesophageal reflux disease (GERD)-related disorders of systemic sclerosis (SSc) patients have not been adequately investigated.

Methods: Sixty-six SSc patients (5 males and 61 females; 56.6 ± 14.6 years old) who underwent esophagogastroduodenoscopy were analyzed on the basis of 16 background factors. They were additionally compared with 116 matched non-SSc subjects controlling age, sex, and use of proton pump inhibitors (PPIs).

Results: The mean disease duration of 66 patients was 5.1 ± 8.1 years, and their breakdown was as follows: 53 (80.3%) with GERD, 38 (57.6%) with GERD-related symptoms, and 20 (30.3%) with reflux esophagitis (RE; LA-A: 10, LA-B: 5, LA-C: 4, LA-D: 1). Use of PPI (p = 0.0455), complication of interstitial lung disease (p = 0.0242), and history of cyclophosphamide therapy (p = 0.0184) denoted significant association with GERD-related symptoms. Older age (p = 0.0211) was significantly associated with RE. None of GERD-related disorders showed any difference between 37 diffuse cutaneous SSc and 29 limited cutaneous SSc patients. The matched analysis indicated that SSc patients had higher prevalence of GERD (p < 0.0001), GERD-related symptoms (p = 0.0034), and RE (p = 0.0002).

Conclusion: SSc patients tend to have worse GERD symptoms and severer RE. However, most SSc-associated factors did not show significant association with GERD-related disorders, indicating the difficulty in predicting GERD-related disorders among SSc patients.

Keywords: Frequency scale for the symptoms of gastroesophageal reflux disease; Gastroesophageal reflux disease; Los Angeles classification of gastroesophageal reflux; Non-erosive reflux disease; Reflux esophagitis; Systemic sclerosis.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Case-Control Studies
  • Endoscopy, Digestive System
  • Female
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / drug therapy
  • Gastroesophageal Reflux / epidemiology*
  • Gastroesophageal Reflux / etiology
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Proton Pump Inhibitors / therapeutic use*
  • Scleroderma, Systemic / complications*
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

Substances

  • Proton Pump Inhibitors