UH Offers Advanced Diagnostics and Treatments for Esophageal Scleroderma
Scleroderma is chronic disorder of the immune system that causes your body to make too much collagen, a protein found in your skin. When too much collagen is produced, it can lead to thickening, hardening and tightening of the skin, connective tissues and internal organs. As the disease progresses, it can cause inflammation, scarring and tissue damage.
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Scleroderma is relatively rare but when it does occur, it very often affects the gastrointestinal tract, most commonly the esophagus or food pipe. When this occurs it is called esophageal scleroderma, a condition in which the smooth muscles of the esophagus are damaged and replaced with scar tissue. This causes the esophagus to become narrower and can lead to acid reflux symptoms and swallowing problems.
What are the symptoms of Esophageal Scleroderma?
As the muscles in the esophagus become weaker and narrower due to the buildup of scar tissue, patients with esophageal scleroderma may experience the following symptoms:
- Gastroesophageal reflux disease (GERD)
- Difficult or painful swallowing
- Choking on food or a sensation of food being stuck in your throat
- Bitter taste in the mouth due to undigested food backing up in the esophagus
- Chest pain
How is esophageal scleroderma diagnosed?
If a patient comes to us with symptoms of GI-related symptoms like heartburn or difficulty swallowing, a variety of tests may be performed to rule out or confirm a diagnosis of esophageal scleroderma. These may include:
- Upper endoscopy
A test that uses a flexible tube called an endoscope to look at the inside of the esophagus. The tube has a light and a camera on the end so the doctor can see changes in the esophagus such as inflammation, infection and other abnormalities.
- Esophageal manometry
A nonsurgical, minimally invasive endoscopic test in which the doctor inserts a long, flexible tube called an endoscope into your esophagus. This highly sensitive instrument can measure and evaluate the muscle strength and contractions in the esophagus.
- Barium esophagram
This test uses barium and X-ray technology to look at the size and shape of your esophagus and how well you swallow.
- Esophageal pH testing
This is a 24-hour test in which a small tube with an acid-sensing device on the end is inserted through your nose and into your esophagus. The tube is attached to a special device that records the acidity of your esophagus as you continue to eat and drink normally.
Additional, more advanced tests may be ordered if any of the above procedures identify a problem or concern that needs further investigation.
Treatment for Esophageal Scleroderma
Esophageal scleroderma can lead to a variety of serious complications and health risks so it is important to seek help from an experienced digestive health expert if it is diagnosed or suspected.
Scleroderma-related damage can contribute to or cause:
- Barrett’s Esophagus
- Aspiration pneumonia due to stomach contents backing up and being inhaled into the lungs
- Esophageal strictures – narrowing of the esophagus
Treatments may include:
- Managing symptoms of heartburn and swallowing difficulties through lifestyle and dietary changes
- Medications to reduce and/or neutralize stomach acid production
- Medications to stimulate the GI tract and keep the digestive process moving
- Esophageal dilation. This is an endoscopic procedure done under sedation. It is most often used when the esophagus is severely narrowed due to inflammation and/or scarring. The doctor uses a dilating balloon or plastic dilators to stretch and widen the narrowed section of your esophagus so that swallowing is easier.