Esophageal Manometry in Scleroderma

Esophageal manometry was performed in 21 cases of scleroderma, including a number of patients with mild diseases. Previous reports have emphasized aperistalsis in the lower esophagus as the most characteristic feature but it was found that weakness of contraction was the most common feature. This was often coupled with aperistalsis. Abnormalities of the lower sphincter were common, as was absence of an end-expiratory gastroesophageal gradient. Multiple peaking of responses and segmental weakness were also seen.Most of the abnormalities seen are non-specific. Scleroderma can only be diagnosed manometrically when very marked changes coupled with a negative Mecholyl test are present.