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Gastrointestinal motility disorder assessment in systemic sclerosis

机译：全身性硬化症中胃肠动力障碍的评估

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Objectives: SSc is a clinically heterogeneous and generalized disease, characterized by thickness of the connective tissue of the skin and internal organs, such as the digestive tract, impairing gastrointestinal (GI) motility. Our aim is to evaluate retrospectively abnormalities of oesophageal motility, gastric emptying, oro-cecal transit time (OCTT) and small intestine bacterial overgrowth (SIBO) in a large cohort of SSc patients. Methods: Ninety-nine SSc patients were included in the study. Forty-two patients underwent oesophageal conventional manometry, 45 performed a [13C]octanoic acid breath test to measure gastric emptying time and all 99 patients performed a lactulose breath test in order to evaluate OCTT and SIBO. Data were compared with healthy controls. Results: In SSc patients, median lower oesophageal sphincter (LOS) pressure [14mmHg (25th-75th; 8-19) vs 24mmHg (19-28); P0.01] and median wave amplitude [30mmHg (16-70) vs 72mmHg (48-96); P0.01] were lower than in controls. Oesophageal involvement, defined as reduced LOS pressure and ineffective oesophageal motility pattern, was encountered in 70% of SSc patients. A delayed gastric emptying time was present in 38% of SSc patients: mean t1/2 was 141 ± 79 min vs 90 ± 40 min of controls (P0.01). Also, OCTT was significantly delayed in SSc: median OCTT was 160 min (25th-75th; 135-180) vs 105 min (25th-75th; 90-135) of controls (P0.01). SIBO was observed in 46% of SSc compared with 5% of controls (P0.01). Conclusion: GI involvement is very frequent in SSc patients. Oesophagus and small bowel are more frequently impaired, whereas delayed gastric emptying is less common.
机译：目的：SSc是一种临床上异质性和普遍性疾病，其特征是皮肤和内部器官（例如消化道）的结缔组织厚度增厚，胃肠道（GI）动力受损。我们的目的是回顾性分析大量SSc患者的食管动力，胃排空，盲肠渡越时间（OCTT）和小肠细菌过度生长（SIBO）异常。方法：99例SSc患者被纳入研究。 42例患者接受了食管常规测压，其中45例进行了[13C]辛酸呼气试验以测量胃排空时间，所有99例患者进行了乳果糖呼气试验以评估OCTT和SIBO。将数据与健康对照进行比较。结果：在SSc患者中，食管下括约肌的中位压力（LOS）[14mmHg（25th-75th; 8-19）vs 24mmHg（19-28）; P <0.01]和中值波幅[30mmHg（16-70）vs 72mmHg（48-96）; P ＜0.01]低于对照组。 70％的SSc患者遇到食道受累，定义为LOS压力降低和无效的食道运动模式。 38％的SSc患者胃排空时间延迟：对照组的平均t1 / 2为141±79分钟，而对照组为90±40分钟（P <0.01）。同样，SSTT中的OCTT明显延迟：中位OCTT为160分钟（25-75日; 135-180），而对照组为105分钟（25-75; 90-135）（P <0.01）。与对照组的5％相比，在SSc的46％中观察到了SIBO（P <0.01）。结论：SSc患者胃肠道受累非常频繁。食道和小肠更容易受损，而胃排空延迟的情况则较少见。

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