Esophageal manometry and pH-probe monitoring in the evaluation of gastroesophageal reflux in patients with progressive systemic sclerosis.

Fifty-five patients with progressive systemic sclerosis (PSS) were evaluated with esophageal manometry, 12-h pH-probe monitoring in esophagus, and registration of symptoms of gastroesophageal reflux (GER). Thirty-nine patients had symptoms suggestive of GER. The 12-h pH-monitoring showed pathologic GER in 30 patients. We found that 33% of the patients with symptoms did not have pathologic GER, and 25% of the patients without symptoms had pathologic GER. Characteristic changes of impaired motility in the esophagus were found in 46 patients. When combining esophageal manometry, reflux measurement, and symptoms of GER, we found a positive correlation in 60% of patients with reduced peristalsis in the lower two-thirds of the esophagus and GER. We therefore recommend sensitive esophageal pH-monitoring in all PSS patients to ensure treatment of patients with pathologic GER.