Skip to main content

Advertisement

SpringerLink
Log in

Esophageal transit scintigraphy and structured questionnaire in patients with systemic sclerosis with endoscopically proven reflux esophagitis

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objectives

Esophageal complications are common in patients with systemic sclerosis (SSc). The relationship between gastroesophageal reflux (GER) symptoms and dysmotility was examined in endoscopically confirmed patients suspected of having reflux esophagitis.

Methods

A total of 32 patients with limited and diffuse type SSc (lSSc, dSSc) were examined based on a structured questionnaire score (QS) of GER symptoms, retention fraction of esophageal scintigraphy at 90 s (R 90) and gastric emptying time.

Results

The QS was significantly higher in the reflux esophagitis group than in the non-esophagitis group (5.4 ± 3.5, 1.4 ± 2.9, P = 0.003). When the non-esophagitis group was further divided into lSSc and dSSc groups, R 90 was higher in the reflux esophagitis group (31 ± 18%) and the non-esophagitis group with dSSc (34 ± 32%) than in the non-esophagitis group with lSSc (8 ± 3%, P = 0.02). Both high R 90 ≥ 15% and QS ≥ 4 indicated reflux esophagitis. Conversely, both normal R 90 and QS indicated no reflux esophagitis.

Conclusion

A combination of esophageal scintigraphy and structured questionnaire demonstrated different aspects of esophageal dysfunction, namely dysmotility and GER. Patients with high QS and dysmotility may be indicated for further evaluation including endoscopic examination and medical treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. D’angelo W, Fries J, Masi A, Shulman L. Pathologic observation in systemic sclerosis (scleroderma). A study of fifty-eight autopsy cases and fifty-eight matched controls. Am J Med. 1969;46:428–40.

    Article  PubMed  Google Scholar 

  2. Pitrez EH, Bredemeier M, Xavier RM, Capobianco KG, Restelli VG, Vieira MV, et al. Oesophageal dysmotility in systemic sclerosis: comparison of HRCT and scintigraphy. Br J Radiol. 2006;79:719–24.

    Article  CAS  PubMed  Google Scholar 

  3. Mariani G, Boni G, Barreca M, Bellini M, Fattori B, AlSharif A, et al. Radionuclide gastroesophageal motor studies. J Nucl Med. 2004;45:1004–28.

    PubMed  Google Scholar 

  4. Klein HA, Wald A, Graham TO, Campbell WL, Steen VD. Comparative studies of esophageal function in systemic sclerosis. Gastroenterology. 1992;102:1551–6.

    CAS  PubMed  Google Scholar 

  5. Davidson A, Russell C, Littlejohn GO. Assessment of esophageal abnormalities in progressive systemic sclerosis using radionuclide transit. J Rheumatol. 1985;12:472–7.

    CAS  PubMed  Google Scholar 

  6. Russell CO, Hill LD, Holmes ER 3rd, Hull DA, Gannon R, Pope CE 2nd. Radionuclide transit: a sensitive screening test for esophageal dysfunction. Gastroenterology. 1981;80:887–92.

    CAS  PubMed  Google Scholar 

  7. Maddern GJ, Horowitz M, Jamieson GG, Chatterton BE, Collins PJ, Roberts-Thomson P. Abnormalities of esophageal and gastric emptying in progressive systemic sclerosis. Gastroenterology. 1984;87:922–6.

    CAS  PubMed  Google Scholar 

  8. Carette S, Lacourciere Y, Lavoie S, Halle P. Radionuclide esophageal transit in progressive systemic sclerosis. J Rheumatol. 1985;12:478–81.

    CAS  PubMed  Google Scholar 

  9. Nakajima K, Kawano M, Kinuya K, Sato S, Takehara K, Tonami N. The diagnostic value of oesophageal transit scintigraphy for evaluating the severity of oesophageal complications in systemic sclerosis. Nucl Med Commun. 2004;25:375–81.

    Article  PubMed  Google Scholar 

  10. Ntoumazios SK, Voulgari PV, Potsis K, Koutis E, Tsifetaki N, Assimakopoulos DA. Esophageal involvement in scleroderma: gastroesophageal reflux, the common problem. Semin Arthritis Rheum. 2006;36:173–81.

    Article  PubMed  Google Scholar 

  11. LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr, et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol. 1988;15:202–5.

    CAS  PubMed  Google Scholar 

  12. LeRoy EC, Medsger TA Jr. Criteria for the classification of early systemic sclerosis. J Rheumatol. 2001;28:1573–6.

    CAS  PubMed  Google Scholar 

  13. Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45:172–80.

    Article  CAS  PubMed  Google Scholar 

  14. Numans ME, de Wit NJ. Reflux symptoms in general practice: diagnostic evaluation of the Carlsson-Dent gastro-oesophageal reflux disease questionnaire. Aliment Pharmacol Ther. 2003;17:1049–55.

    Article  CAS  PubMed  Google Scholar 

  15. Carlsson R, Dent J, Bolling-Sternevald E, Johnsson F, Junghard O, Lauritsen K, et al. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol. 1998;33:1023–9.

    Article  CAS  PubMed  Google Scholar 

  16. Nagano K, Kubo M, Goto M, Tatsuta M, Iishi H, Kanda T, et al. The diagnosis of GERD: a study by questionnaire (QUEST) in patients complaining upper digestive symptoms [in Japanese]. J New Rem Clin. 1998;47:841–51.

    Google Scholar 

  17. Weston S, Thumshirn M, Wiste J, Camilleri M. Clinical and upper gastrointestinal motility features in systemic sclerosis and related disorders. Am J Gastroenterol. 1998;93:1085–9.

    Article  CAS  PubMed  Google Scholar 

  18. Wegener M, Adamek RJ, Wedmann B, Jergas M, Altmeyer P. Gastrointestinal transit through esophagus, stomach, small and large intestine in patients with progressive systemic sclerosis. Dig Dis Sci. 1994;39:2209–15.

    Article  CAS  PubMed  Google Scholar 

  19. Tsugeno H, Mizuno M, Fujiki S, Okada H, Okamoto M, Hosaki Y, et al. A proton-pump inhibitor, rabeprazole, improves ventilatory function in patients with asthma associated with gastroesophageal reflux. Scand J Gastroenterol. 2003;38:456–61.

    Article  CAS  PubMed  Google Scholar 

  20. Kinuya K, Nakajima K, Kinuya S, Michigishi T, Tonami N, Takehara K. Esophageal hypomotility in systemic sclerosis: close relationship with pulmonary involvement. Ann Nucl Med. 2001;15:97–101.

    Article  CAS  PubMed  Google Scholar 

  21. Nakajima K, Kawano M, Kinami S, Fujimura T, Miwa K, Tonami N. Dual-radionuclide simultaneous gastric emptying and bile transit study after gastric surgery with double-tract reconstruction. Ann Nucl Med. 2005;19:185–91.

    Article  PubMed  Google Scholar 

  22. Marie I, Ducrotte P, Denis P, Hellot MF, Levesque H. Oesophageal mucosal involvement in patients with systemic sclerosis receiving proton pump inhibitor therapy. Aliment Pharmacol Ther. 2006;24:1593–601.

    Article  CAS  PubMed  Google Scholar 

  23. Lock G, Pfeifer M, Straub RH, Zeuner M, Lang B, Scholmerich J, et al. Association of esophageal dysfunction and pulmonary function impairment in systemic sclerosis. Am J Gastroenterol. 1998;93:341–5.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by funds for research on intractable diseases from the Ministry of Health, Labour and Welfare of Japan (2006–2008).

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641, Japan

    Kenichi Nakajima, Anri Inaki, Takashi Hiramatsu & Seigo Kinuya

  2. Department of Dermatology, Kanazawa University Hospital, Kanazawa, Japan

    Minoru Hasegawa, Manabu Fujimoto & Kazuhiko Takehara

Authors
  1. Kenichi Nakajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anri Inaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takashi Hiramatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Minoru Hasegawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Manabu Fujimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kazuhiko Takehara
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seigo Kinuya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenichi Nakajima.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakajima, K., Inaki, A., Hiramatsu, T. et al. Esophageal transit scintigraphy and structured questionnaire in patients with systemic sclerosis with endoscopically proven reflux esophagitis. Ann Nucl Med 23, 771–776 (2009). https://doi.org/10.1007/s12149-009-0310-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-009-0310-0

Keywords

Search

Navigation