Gastroesophageal Reflux Disease and Connective Tissue Disorders: Pathophysiology and Implications for Treatment

摘要: It has been postulated that in patients with connective tissue disorders (CTD) and gastroesophageal reflux disease (GERD), esophageal function is generally deteriorated, often complete absence of peristalsis. This belief led to the common recommendation avoiding antireflux surgery for fear creating or worsening dysphagia. We hypothesized most CTD GERD: (a) preserved; (b) peristalsis more frequently absent when end-stage lung (ESLD) also present; (c) a tailored surgical approach (partial total fundoplication) based on findings manometry allows control symptoms without high incidence postoperative Forty-eight were evaluated by 24-hour pH monitoring (EFT). Twenty (group A) had EFT because foregut symptoms, 28 ESLD B) as part transplant evaluation. Two hundred eighty-six consecutive GERD served group C). A laparoscopic fundoplication was performed two (total), eight B (three total, five partial) all C (total). Esophageal preserved GERD. In contrast, about half present. resulted patients. One patient only developed dysphagia, which resolved Savary dilatations. These data show motor CTD, so they should be offered early course their prevent respiratory complications. whom absent, partial rather than performed, it while