RESEARCH - Dysphagia and dysmotility of the pharynx and oesophagus in patients with primary Sjögren's syndrome

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Scand J Rheumatol. 2007 Sep-Oct;36(5):394-401.

Dysphagia and dysmotility of the pharynx and oesophagus in patients

with primary Sjögren's syndrome.

Mandl T, Ekberg O, Wollmer P, Manthorpe R, sson LT.

Department of Rheumatology, Malmö University Hospital, Malmö, Sweden.

OBJECTIVES: To assess the prevalence of pharyngeal and oesophageal

symptoms and dysmotility in patients with primary Sjögren's syndrome

(pSS) and relate these to autonomic nervous function. METHODS: Twenty

consecutive pSS patients, according to the American-European Consensus

Criteria (AECC), and 30 age- and sex-matched controls from the Swedish

general population registry were studied. All subjects completed a

pharyngeal and oesophageal symptoms questionnaire and were examined by

pharyngeal and oesophageal video radiography. In addition, the pSS

patients were examined by two different autonomic nervous function

tests, the deep breathing test [calculating the expiration/inspiration

(E/I) ratio] and the finger skin blood flow test [the vasoconstriction

(VAC) index]. RESULTS: pSS patients experienced significantly more

dysphagia compared with controls (65% vs. 3%; p<0.001). Pharyngeal

(45% vs. 7%; p<0.01), oesophageal (80% vs. 7%; p<0.001) and

gastro-oesophageal reflux symptoms (60% vs. 23%; p<0.01) were also

more prevalent in pSS patients compared with controls while pharyngeal

(15% vs. 17%; p = NS) and oesophageal dysmotility (40% vs. 30%; p =

NS) were not. Dysphagia was not associated with dysmotility but was

found to be associated with a decreased E/I ratio [-1.05 (-1.51 to

-0.40) in patients with dysphagia vs. -0.21 (-0.39 to 0.65) in

patients without dysphagia; p<0.01].

CONCLUSION: Subjective swallowing difficulties were more common in pSS

patients than in controls while objective signs of pharyngeal and

oesophageal dysmotility were not. Dysphagia in pSS patients does not

seem to be related to video radiographical signs of dysmotility but

may be related to an impaired parasympathetic function.

PMID: 17963171

http://www.ncbi.nlm.nih.gov/pubmed/17963171

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