Upper gastrointestinal endoscopy in systemic sclerosis: A cross sectional study

Tasleem Arif; Mohammad Adil; Jaswinder Singh Sodhi

Background and Aims Involvement of the gastrointestinal tract is common in systemic sclerosis. The aim of this study was to identify the frequency and severity of dyspeptic symptoms in systemic sclerosis patients and to identify the common patterns of upper gastrointestinal endoscopic pathology from Kashmir valley, the study being first of its kind in the region. Methods Thirty seven sequential, newly and already diagnosed cases of systemic sclerosis were taken up for the study. This included 28 patients with limited systemic sclerosis and 9 patients with diffuse disease. They were enquired about the frequency and severity of symptoms of dysphagia, acid regurgitation and heartburn. Patients were then subjected to upper gastrointestinal endoscopy to identify abnormal findings. Results Esophageal symptoms were present in 26 (70.3%) patients. 17 (60.7%) patients with limited disease showed esophageal symptoms while all 9 (100%) patients with diffuse disease showed these symptoms (p=0.025). Upper gastrointestinal endoscopy showed abnormal findings in 23 (62.2%) patients. Esophagus was most frequently involved organ with abnormalities seen in 15 (40.5%) patients, followed by involvement of the stomach in 13 (35.1%) patients and the duodenum in 5 (13.5%) patients. Reflux esophagitis was the commonest abnormality, seen in 12 (32.4%). Conclusion Esophageal symptoms are a common occurrence in systemic sclerosis patients and seem to occur with a greater frequency in the diffuse disease subset. There seems to be no statistical difference between the two disease subsets in terms of the severity of the symptoms. Esophagitis appears to be the most common finding on upper gastrointestinal endoscopy.