Sistemik Skleroz’da Özofagus Tutulumu ve Gastroözofageal Reflü Hastalığı: Üçüncü Basamak Deneyimi

Abstract

Amaç: Özofagus sistemik sklerozda (SS) en sık tutulan gastrointestinal segmenttir. Özofagus tutulumunun yol açtığı motilite bozukluğu ile ortaya çıkan gastroözofageal reflü hastalığı, birçok lokal ve sistemik komplikasyon nedeniyle hastalığın seyrinde önemli bir yere sahiptir. Bu çalışmamızda SS tanılı hastaların demografik özelliklerini, endoskopik, manometrik ve 24 saatlik ph monitorizasyonu bulgularını araştırdık. Gereç ve Yöntem: Disfaji veya heartburn şikayetleri ile başvurmuş olan 26 SS tanılı hasta tespit edildi. Hastaların, dosyaları, endoskopik, manometrik ve özofagusun 24 saatlik ph monitorizasyonu bulguları incelendi. Bulgular: Hastaların tamamı semptomatikti, %96,1’i kadındı. %46,1 ’i heartburn şikayetiyle, %53,9’u disfaji şikayetiyle başvurmuştu. Özofajit sıklığı anlamlı ölçüde yüksek saptandı (p=0,005). 24 saatlik ph monitorizasyonu yapılan hastaların %90’ında patolojik reflü tespit edilmişti ve anlamlı derecede yüksekti (p=0,013). Sonuç: Özofageal tutulum SS' nin karakteristik tutulumlarından biridir. Özofagus tutulumu, heartburn ve disfaji gibi şikayetler ile kendini gösterir. Toplumumuzda, özofagus semptomları olan SS hastalarında GÖRH ve GÖRH ile ilişkili komplikasyonların görülme sıklığı yüksektir. Bu hastaların öncelikle endoskopik ve sonra diğer tanı yöntemleri ile değerlendirilmesi için deneyimli gastroenteroloji merkezlerine yönlendirilmesi önem arz etmektedir.

Keywords

• gastroözofageal reflü hastalığı
• özofafus motilite bozuklukları
• sistemik skleroz

Esophageal Involvement and Gastroesophageal Reflux Disease in Systemic Sclerosis: A Tertiary Center Experience

Abstract

Aim: Esophagus is the most frequently involved gastrointestinal segment in systemic sclerosis (SS). Gastroesophageal reflux, which occurs with the motility disorder caused by esophageal involvement, has an important place in the course of the disease due to many local and systemic complications. In this study, we investigated the demographic features, endoscopic, manometric, and 24-hour pH monitoring findings of patients with SS. Materials and Methods: Twenty-six patients with SS who presented with dysphagia or heartburn complaints were identified. Patients' files, endoscopic, manometric, and 24-hour ph monitoring findings of the esophagus were examined. Results: All of the patients were symptomatic, 96.1% were women. 46.1% of them applied with the complaint of heartburn and 53.9% with the complaint of dysphagia. The frequency of esophagitis was found to be significantly higher (p = 0.005). Pathological reflux was detected in 90% of the patients who underwent 24-hour pH monitoring and it was significantly higher (p = 0.013). Conclusion: Esophageal involvement is a hallmark manifestation of SS and typically occurs secondary to heartburn and dysphagia.In our society, the incidence of GERD and GERD-related complications is high in SS patients with esophageal symptoms. It is important to refer these patients to experienced gastroenterology centers to be evaluated primarily by endoscopic and then other diagnostic methods.

Keywords

• esophageal motility disorder
• gastroesophageal reflux disease
• systemic sclerosis

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