Comparative Esophageal and Anorectal Motility in Scleroderma

Hamel-Roy, Joann; Devroede, Ghislain; Arhan, Pierre; Tétreault, L; Duranceau, André; Ménard, Henri-André

doi:10.1016/s0016-5085(85)80124-4

Cited by 82 publications

(26 citation statements)

References 10 publications

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“…A comparative study of anorectal and esophageal manometry showed that anorectal motility is as frequently abnormal as esophageal motility. 24 Clinically, patients may experience constipation and fecal impaction and have rectal prolapse, megacolon, and diverticula. Other possible complications include stercoral ulcerations, colonic perforation and infarction.…”

Section: Large Intestine Rectum Anusmentioning

confidence: 99%

Gastrointestinal Manifestations of Systemic Lupus Erythematosus and Scleroderma

Daruwala

Mercogliano

Harder

2009

Clinical Medicine. Gastroenterology

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Abstract:In this review, we analyze the effects of systemic lupus erythematosus and scleroderma on the gastrointestinal tract. There is a wide variation of gastrointestinal manifestations from these autoimmune disorders including but not limited to: oral ulcers, dysphagia, gastroesophageal refl ux disease, abdominal pain, constipation, diarrhea, fecal incontinence, pseudo-obstruction, perforation and gastrointestinal bleeding. The purpose of this review is to discuss these manifestations, the appropriate diagnostic tests, and treatment.Keywords: systemic lupus erythematosus, scleroderma, gastrointestinal manifestations Systemic Lupus ErythematosusSystemic Lupus Erythematosus (SLE) is a multisystem disease characterized by antinuclear antibodies and complement deposition. The disease affects women more then men (especially African-American women) with a reported female/male ratio of 10:1.1 Gastrointestinal (GI) complications are common in patients with active SLE. In 1895, William Osler was the fi rst to describe how the GI complications of SLE can mimic any type of abdominal condition and overshadow the other organ complications associated with SLE. Gastrointestinal complications can lead to a variety of symptoms across a large portion of the GI tract. Up to 50% of patients will experience anorexia, nausea or vomiting. Oral Cavity and SLEOral or nasopharyngeal ulceration, usually painless, observed by a physician is one of the eleven diagnostic criteria of SLE. Mucous membrane involvement occurs in 12%-45% of patients. The wide variation may be explained by demographic differences. One cross-sectional analysis reported that 46% of English patients with SLE had oral lesions compared to 15% of patients in Brazil and 11% of patients in Sweden.2 Another study reported oral ulcerations at a prevalence of 26% in an Arab population of SLE patients, and noted a signifi cant association with the presence of anti-smith antibodies (P = 0.033). 3Causes of the mucosal ulcerations include the underlying disease activity, associated Sjogren's syndrome, intra-oral infections and complications associated with treatment.The ulcers are generally classifi ed as either discoid, erythematous or ulcerative. Discoid lesions, characterized by erythema, atrophy, and depigmentation, usually occur on the lips. Punched-out erosions/ ulcers with surrounding erythema, irregularly shaped raised white plaques, and areas of erythema tend to occur on the hard or soft palate and the buccal mucosa. The discoid lesions are painful while the erythematous lesions (the majority) are painless. It has been reported by Jonsson et al that only those patients with active disease can have ulcerative and discoid lesions. However, they found no correlation between overall prevalence of oral lesions and SLE disease activity. 4 The treatment options for oral lesions include topical glucocorticoids, tacrolimus ointment, intralesional corticoids, and systemic antimalarial drugs. Most lesions respond to steroids in days to weeks. EsophagusDysphagia occurs in 1.5%-1...

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Section: Large Intestine Rectum Anusmentioning

confidence: 99%

Gastrointestinal Manifestations of Systemic Lupus Erythematosus and Scleroderma

Daruwala

Mercogliano

Harder

2009

Clinical Medicine. Gastroenterology

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“…As many as 90% of SSc patients have gastrointestinal (GI) symptoms (9,13), usually involving the esophagus, and 50 -70% may involve anorectum (21,44). Diarrhea, constipation, fecal incontinence, and abdominal distension are commonly present in this patient population (30,44).…”

mentioning

confidence: 99%

Immunoglobulins from scleroderma patients inhibit the muscarinic receptor activation in internal anal sphincter smooth muscle cells

Singh¹,

Mehendiratta²,

Galdo

et al. 2009

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…Manometry studies in early scleroderma show increased velocity of the peristaltic wave, discordance of the peristaltic wave with LES relaxation, and failure of the LES to relax to baseline. Later findings include decreased amplitude of peristalsis and low LES resting pressure progressing to aperistalsis in the smooth muscle portion of the esophagus with absent LES resting pressure 14,15 . Gastroesophageal reflux disease (GERD) is the most significant clinical condition.…”

Section: Discussionmentioning

confidence: 99%

A Case of Chronic Intestinal Pseudo-Obstruction

Baichi¹

2003

TMF

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Comparative Esophageal and Anorectal Motility in Scleroderma

Cited by 82 publications

References 10 publications

Gastrointestinal Manifestations of Systemic Lupus Erythematosus and Scleroderma

Gastrointestinal Manifestations of Systemic Lupus Erythematosus and Scleroderma

Immunoglobulins from scleroderma patients inhibit the muscarinic receptor activation in internal anal sphincter smooth muscle cells

A Case of Chronic Intestinal Pseudo-Obstruction

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