Partial Fundoplication is Effective Treatment for Female Patients with Gastroesophageal Reflux and Scleroderma: A Multicenter Comparative Cohort Study

Hii, Amanda; Liu, David Shi Hao; Kholmurodova, Feruza; Irvine, Tanya; Bright, Tim; Watson, David I.; Thompson, Sarah K.

doi:10.1007/s00268-021-06326-7

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…A study involving 65 SSc patients suggested polidocanol injections as a useful and possible treatment for SScrelated small-bowel angioectasia (99). Hii et al reported a significant improvement of heartburn in SSc patients with GERD at 3 months, and at 1 and 3 years after partial fundoplication (100).…”

Section: Gastrointestinal Involvementmentioning

confidence: 99%

Systemic sclerosis: one year in review 2022

Lepri

Orlandi

Battista

et al. 2022

Clinical and Experimental Rheumatology

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Section: Gastrointestinal Involvementmentioning

confidence: 99%

Systemic sclerosis: one year in review 2022

Lepri

Orlandi

Battista

et al. 2022

Clinical and Experimental Rheumatology

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Toupet fundoplication to prevent progression of scleroderma-associated interstitial lung damage: a study protocol

Aiolfi,

Bona,

Manara

et al. 2024

Eur Surg

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Summary Background Systemic sclerosis (SSc) is a rare autoimmune and multiorgan disorder. Hallmarks of the disease include inflammation, endothelial dysfunction, and dysregulation of fibroblasts leading to fibrosis of the skin and internal organs. The esophagus is often involved, with up to 80% of patients developing gastroesophageal reflux disease (GERD). Reflux can be associated with hiatal hernia and several complications such as erosive esophagitis, peptic stricture, Barrett’s esophagus, aspiration pneumonia, and chronic microaspiration. Silent aspiration can lead to interstitial lung disease (ILD) in up to 50% of patients with scleroderma and accounts for up to 40% of mortality. Treatment of GERD in patients with SSc is challenging. Proton pump inhibitors (PPI) have been shown effective in relieving typical GERD symptoms, but up to 40% of patients are non-responders. Various antireflux surgical procedures have been proposed to treat GERD and to modify the natural course of the disease by preventing lung damage in these patients. However, current algorithms consider only the degree of esophageal dilation as a marker of disease severity/progression, and results of antireflux surgery remain controversial. Methods We propose a feasibility, observational, multicenter, single-arm trial including adult patients diagnosed with SSc. Criteria for inclusion are individuals with GERD symptoms refractory to PPI, absence of peptic stricture at baseline endoscopy, high-resolution computed tomography (HRCT) scan showing no or less than 10% lung fibrosis, forced vital capacity at least 40% of the predicted value, and diffusing capacity of lung for carbon monoxide 30–89% of the predicted value. A laparoscopic partial posterior fundoplication according to the Toupet technique will be performed. Primary study outcome is the efficacy of fundoplication to reduce reflux exposure measured with a pH-impedance study or 4‑day wireless pH recording. Secondary outcomes include endoscopic, HRCT, and respiratory function tests findings as well as quality of life at 12-month follow-up. Conclusions The expected reduction of reflux burden in SSc patients selected for Toupet fundoplication may improve GERD symptoms/complications, pulmonary function, and quality of life, and may be associated with a reduced risk for lung transplant.

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Autoimmune dysphagia

Tai,

Suppiah

2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review Dysphagia is a complication of several autoimmune rheumatic diseases and otorhinolaryngologists are likely to be involved in the assessment and management of patients with such conditions. This review provides an update on rheumatic diseases that may cause swallowing impairment, with particular focus on the epidemiology, pathophysiology and management of dysphagia in these conditions. Recent findings Dysphagia is a common complication of the following rheumatic diseases: idiopathic inflammatory myopathies, systemic sclerosis, Sjogren's syndrome, systemic lupus erythematosus and rheumatoid arthritis. It may also be a complication of rarer autoimmune conditions such as Bechet's syndrome, sarcoidosis and granulomatosis with polyangiitis. All three stages of swallowing (oral, pharyngeal and oesophageal) may be impaired in these conditions. Both medical therapy and surgical intervention play an important role in the management of autoimmune dysphagia. Summary The investigation and management of autoimmune dysphagia requires close collaboration between rheumatologists and otorhinolaryngologists. There is a need for further research to establish standardised guidelines on the assessment and management of autoimmune dysphagia.

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Partial Fundoplication is Effective Treatment for Female Patients with Gastroesophageal Reflux and Scleroderma: A Multicenter Comparative Cohort Study

Cited by 3 publications

References 33 publications

Systemic sclerosis: one year in review 2022

Systemic sclerosis: one year in review 2022

Toupet fundoplication to prevent progression of scleroderma-associated interstitial lung damage: a study protocol

Autoimmune dysphagia

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