MANOMETRIC ASSESSMENT OF ESOPHAGEAL MOTILITY IN PATIENTS WITH PRIMARY BILIARY CIRRHOSIS

¹M. BEKTAS, ¹G. SEVEN, ¹R. IDİLMAN, ¹M. YAKUT, ²B. DOĞANAY, ¹G. KABACAM, ¹ Y. USTUN, ¹O. KESKİN, ¹E. KORKUT, ¹H. ANİKTAR, ³G. SAHİN, ¹H. CETİNKAYA, ¹H. BOZKAYA, ¹C. YURDAYDIN, ¹K. BAHAR, ¹I. SOYKAN

Ankara University School of Medicine, Ankara, TURKEY

Introduction/aim: Primary biliary cirrhosis (PBC) is associated with other autoimmune diseases such as Sjögren’s syndrome (SS), autoimmune thyroiditis, rheumatoid arthritis, and scleroderma. Esophageal motility abnormalities are well known in scleroderma, SS, and some rheumatic diseases with sicca syndrome. However data about esophageal motility in patients with PBC is lacking The aim of this study is to investigate whether any esophageal motor dysfunction exists in patients with PBC.

Method: The study was performed in 37 pateints (36 women, mean age: 56.3±10.0 years) who met clinical, biochemical and histological criteria for PBC. Thirty-one healthy, age-matched individuals were also included in the study as a control group. Patients entering the study were asked to complete a symptom questionnaire concerning the presence of heartburn, dysphagia and epigastric pain. Esophageal manometry was performed by using a single catheter containing 8 microperfusion state pressure transducers spaced at 5 cm intervals and attached to an online computer. Lower or higher distal esophagus contraction amplitude, hypotansive or hypertensive lower esophageal sphincter pressure were diagnosed as having esophageal dysmotility.

Results: Epigastric pain was observed in 7(18.9%), dysphagia in 6 (16.2%), and heartburn in 5 (13.5%) of the patients. Of 37 patients who had undergone upper GI endoscopy, 4 patients had esophagitis. Manometric findings, in PBC patients vs. controls were as follows: LES pressure (mmHg; x±SD): 24.56±9.56 vs 20.24±7.59, p=0.03; distal esophagus contraction amplitude (mmHg; x±SD): 76.18±39.55 vs 60.94±23.91, p=0.05); LES relaxation duration (sc, x±SD): 6.10±1.18 vs 8.29±1.92, p=0.000, respectively. No significant differences was evident in median LES relaxation (%, x±SD) (93.67±5.90 vs 95.78±5.59, p=0.11), and median peak velocity (sc) (4.27±4.87 vs 3.45±1.61), p=0.34) between patients with PBC and the control group, respectively. Esophageal dysmotility was detected in 16 of 37 patients (43.2%) with PBC, but in none of the healthy volunters. 21 patients met clinical criteria for SS. Esophageal dysmotility was seen in 10 (48%) PBC with SS and in 6 (38%) patients without SS (p>0.05).

Conclusion: In this study esophageal dysmotility was detected 43.2 % of patients. None of these patients were clinically symptomtic. The study suggest that subclinic esophageal dysmotility is frequent in patients with PBC and is independent of the stage of liver disease. We did not find the efect of SS on the esophageal manometric findings. Long-term follow-up of such patients is needed

Date: 2014-12-28; view: 824