The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Pulmonary Function and Gastroesophageal Reflux in Systemic Sclerosis

Matthew B. Troshinsky, MD; Gregory C. Kane, MD; John Varga, MD; Jacqueline R. Cater, PhD; James E. Fish, MD; Sergio A. Jimenez, MD; and Donald O. Castell, MD
[+] Article, Author, and Disclosure Information

From Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; The Graduate Hospital, Philadelphia, Pennsylvania. Requests for Reprints: Donald O. Castell, MD, Department of Medicine, The Graduate Hospital, 1800 Lombard Street, Suite 501, Pepper Pavilion, Philadelphia, PA 19146. Acknowledgments: The authors thank Susan L. Georgeson, RN, MSN, Susie F. Denuna, and Debra Bruestle for their technical and secretarial assistance. Grant Support: In part by grants AR42309 and AR19106 from the National Institutes of Health.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(1):6-10. doi:10.7326/0003-4819-121-1-199407010-00002
Text Size: A A A

Objective: To determine the relations among esophageal dysfunction, gastroesophageal reflux, and lung involvement in patients with systemic sclerosis.

Design: Retrospective review of esophageal motility, esophageal pH, and pulmonary function data.

Setting: University hospital outpatient clinic and community.

Patients: 39 consecutively referred patients who were grouped according to the presence or absence of abnormal distal (pH <4.0 for >5% of the 24-hour monitoring period) or proximal (pH <4.0 for >1% of the 24-hour period) gastroesophageal acid reflux. Patients were also grouped according to the presence or absence of distal esophageal peristalsis.

Measurements: Esophageal manometry, dual-probe (distal and proximal) esophageal 24-hour pH measurements, and pulmonary function studies (forced vital capacity, forced expiratory volume at 1 second, total lung capacity, and single-breath carbon monoxide diffusing capacity [DLCO]).

Results: The mean total lung capacity (values as percentage predicted) was 87.1% ±11.2% (SD) for patients with abnormal proximal reflux and 77.8% ±21.6% for patients with normal proximal reflux (difference, 9.3%; 95% CI, −1.4% to 20.0%). The mean forced vital capacity for these patients was 91.1% ±12.4% and 85.4% ±25.6%, respectively (difference, 5.7%; CI, −6.9% to 18.1%). The mean total lung capacity was 83.8% ±15.4% for patients with abnormal distal reflux and 77.9% ±22.7% for patients with normal distal reflux (difference, 5.9%; CI, −7.6% to 19.4%). Among potential confounders of pulmonary measures, only smoking was related to decreased pulmonary function (smoking related to decreased DLCOP < 0.01). Smoking was more common in patients with abnormal distal reflux than in those with normal distal reflux (65% compared with 25%, P = 0.03). After adjusting for smoking, the difference in mean DLCO between patients with abnormal compared with normal distal reflux was 7.19% (CI, −8.5% to 22.9%).

Conclusion: Important measures of lung volume indicative of interstitial lung disease (total lung capacity, forced vital capacity) do not appear to be related to abnormal gastroesophageal acid reflux in patients with systemic sclerosis.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.