Dysphagia, reflux and related sequelae due to altered physiology in scleroderma

Table 1 Features of various diagnostic studies in systemic sclerosis diagnosis

Diagnostic study	Role in SSc
Esophagogastroduodenoscopy	Evaluates for esophageal causes of dysphagia[4]
	Shows reflux-related complications: erosive esophagitis, strictures, Barrett’s esophagus, esophageal adenocarcinoma[4]
	Reveals esophageal findings in asymptomatic patients[4]
Esophageal manometry	Detects esophageal dysmotility, even in early stages of SSc[4]
	Shows decreased lower esophageal sphincter pressure and absent peristalsis in distal two-thirds of esophagus[4]
Pharyngeal manometry	Evaluates for oropharyngeal dysphagia by assessing upper esophageal sphincter relaxation and pharyngeal propulsion[38]
Esophageal pH monitoring (with or without impedance)	Gold standard for gastroesophageal reflux detection[4]
	Used for patients with resistant reflux[4]
Videofluorography swallow study of esophagus	Shows esophageal dysmotility with decreased peristalsis in distal 2/3 of esophagus[13]
	Shows decrease of lower esophageal sphincter pressure[13]
	Shows dilated lumen of esophagus[13]
CT chest	Shows esophageal dilation[13]

SSc: Systemic sclerosis; CT: Computed tomography.