TY - JOUR
T1 - Abnormal postcibal antral and small bowel motility due to neuropathy or myopathy in systemic sclerosis
AU - Greydanus, Martin P.
AU - Camilleri, Michael
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1989/1
Y1 - 1989/1
N2 - Two hypotheses were tested: first, that postcibal motility disorders occur in both the antrum and small bowel of systemic sclerosis patients with gastrointestinal symptoms; second, that dysmotility may result from a neuropathic stage in this disease. Upper gut perfusion manometry (3 h fasting, 2 h fed) was performed and compared with data from similarly studied healthy laboratory controls (n = 15). Only 1 of 8 scleroderma patients had an interdigestive motor complex during the 3-h fasting period [0.1 ± 0.1 (SEM) for systemic sclerosis vs. 1.4 ± 0.16 (SEM) for controls, p < 0.05]; 2 other patients had fasting duodenal incoordinated bursts of phasic pressure activity in the duodenum or proximal jejunum. Distal antral motility index [MI = In (sum of amplitude × number of contractions + 1)] was lower (12.4 ± 0.5, p < 0.01) than that in controls (14.4 ± 0.14); both the amplitude and frequency of antral pressure activity were lower (p < 0.05) in systemic sclerosis. The intestinal fed pattern was characterized by reduced amplitude and frequency of contractions in 6 patients; 2 patients had excessive phasic or tonic small bowel pressure activity, or both. Thus, antral hypomotility is present in most symptomatic scleroderma patients; proximal small bowel postcibal motility is characteristically reduced; a minority of such patients have incoordinated fasting or postcibal hypermotility suggestive of a neuropathy. Manometry identifies the type and region of dysmotility in systemic sclerosis; our results suggest that there are neuropathic and myopathic stages of the upper gut involvement in systemic sclerosis.
AB - Two hypotheses were tested: first, that postcibal motility disorders occur in both the antrum and small bowel of systemic sclerosis patients with gastrointestinal symptoms; second, that dysmotility may result from a neuropathic stage in this disease. Upper gut perfusion manometry (3 h fasting, 2 h fed) was performed and compared with data from similarly studied healthy laboratory controls (n = 15). Only 1 of 8 scleroderma patients had an interdigestive motor complex during the 3-h fasting period [0.1 ± 0.1 (SEM) for systemic sclerosis vs. 1.4 ± 0.16 (SEM) for controls, p < 0.05]; 2 other patients had fasting duodenal incoordinated bursts of phasic pressure activity in the duodenum or proximal jejunum. Distal antral motility index [MI = In (sum of amplitude × number of contractions + 1)] was lower (12.4 ± 0.5, p < 0.01) than that in controls (14.4 ± 0.14); both the amplitude and frequency of antral pressure activity were lower (p < 0.05) in systemic sclerosis. The intestinal fed pattern was characterized by reduced amplitude and frequency of contractions in 6 patients; 2 patients had excessive phasic or tonic small bowel pressure activity, or both. Thus, antral hypomotility is present in most symptomatic scleroderma patients; proximal small bowel postcibal motility is characteristically reduced; a minority of such patients have incoordinated fasting or postcibal hypermotility suggestive of a neuropathy. Manometry identifies the type and region of dysmotility in systemic sclerosis; our results suggest that there are neuropathic and myopathic stages of the upper gut involvement in systemic sclerosis.
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U2 - 10.1016/0016-5085(89)90770-1
DO - 10.1016/0016-5085(89)90770-1
M3 - Article
C2 - 2909417
AN - SCOPUS:0024579132
SN - 0016-5085
VL - 96
SP - 110
EP - 115
JO - Gastroenterology
JF - Gastroenterology
IS - 1
ER -