Esophageal Motility Disorders

Esophagus in Scleroderma

IM→GI→Esophagus→Motility Disorders→Scleroderma

A 35 year old African American woman presents to your clinic with difficulty swallowing and heart burn. History reveals a diagnosis of scleroderma.

Pathology: Scleroderma causes diffuse fibrosis of the esophagus which results in loss of LES (lower esophageal sphincter) function as well as absent peristalsis of smooth muscle in the distal esophagus.

Presentation: Patients present with dysphagia as well as GERD. They will have history of scleroderma, look for a description of Raynaud’s phenomenon.

Diagnosis: Manometry will show hypotensive/ absent peristalsis and LES tone.

Manometry results for esophageal motility disorders. — from the journal Nature. Esophageal Motility Disorders by W.G. Paterson, Raj K. Goyal and Fortunée Irene Habib. GI Motility online (2006) doi:10.1038/gimo20

Management: Proton pump inhibitors (PPIs).