Scleroderma Esophagus: A Nonspecific Entity

Esophageal dysfunction develops in approximately 90% of patients with progressive systemic sclerosis (scleroderma) or mixed connective tissue disease (1). Abnormal esophageal motility may be one of the earliest manifestations of scleroderma because of smooth muscle involvement (2, 3). Smooth muscle is found in the lower two thirds of the esophagus and in the lower esophageal sphincter. Manometric measurements confirm the incoordination and loss of effective contractions that often progress to complete absence of esophageal contractions and reduced lower esophageal sphincter tone (4). We reviewed esophageal manometric tracings from patients with or without rheumatic disease to determine whether low-amplitude aperistalsis or