Oesophageal and anorectal involvement in systemic sclerosis: a ă systematic assessment high resolution manometry

Résumé En

Objective. In systemic sclerosis (SSc), oesophageal and anorectal ă involvements are frequent and often associated with each other. In ă clinical practice, oesophageal explorations are often prescribed, while ă anorectal explorations are rarely proposed and therefore, ă under-recognised. However, it is well documented in the literature that ă early detection of anorectal dysfunction could delay and/or prevent the ă onset of symptoms such as fecal incontinence (FI). The main objective ă was the systematic evaluation and detection of oesophageal and anorectal ă involvements in SSc patients. ă Methods. In this monocentric retrospective study, all patients with SSc ă addressed in the Department of Functional Digestive Explorations, North ă Hospital, Marseille for oesophageal and anorectal explorations were ă included. Self-Questionnaires, evaluating the symptoms and quality of ă life, were filled by patients during their visit. Explorations were ă performed on the same day: high resolution oesophageal manometry (EHRM), ă 3 Dimensional high resolution anorectal manometry (3DHRARM) and endo ă anal sonography (EUS). ă Results. 44 patients (41 women), mean age 59.8 +/- 12 years, were ă included. With regard to the symptoms, 45.5% of patients had ă gastro-oesophageal reflux disease (GERD), 66.9% dysphagia, 65.9% ă constipation and 773% Fl. The incidence of oesophageal dismotility was ă 65.9%, anorectal and both upper and lower dysfunction were 43.2%. More ă than 89% patients with abnormal explorations (EHRM, 3DHRARM or both) ă were symptomatic. Duration of SSc and altered quality of life was ă correlated with the severity of digestive involvement. ă Conclusion. Anorectal dysfunction appears to be closely linked to ă oesophageal involvement in SSc. Their routine screening is undoubtedly ă essential to limit the occurrence of severe symptoms such as FI.