{
  "abstract": "Introduction Esophageal dysmotility is a frequent and disabling feature of systemic sclerosis (SSc), often presenting with dysphagia, heartburn or reflux. High-resolution manometry (HRM) is key for diagnosis, and multiple rapid swallows (MRS) can assess peristaltic reserve (PR). We aimed to evaluate the association between manometric findings, esophagogastric symptoms, and the role of PR in SSc.Material and Methods Retrospective single-center study including patients with SSc diagnosed by ACR/EULAR 2013 or VEDOSS criteria. Sociodemographic, clinical data (dysphagia, reflux, early satiety) and esophageal manometry findings were collected. Associations between variables were analyzed using x 2 or Fisher’s exact tests.Results Seventy-four SSc patients (90.5% female, mean age 52.4 ± 13.5) were evaluated; 91.9% met ACR/EULAR 2013 and 8.1% VEDOSS criteria. Notably, 63% of patients were receiving proton pump inhibitors, and 9.6% were using prokinetics at the time of manometry.Among the 50 (67.6%) patients with esophagogastric symptoms, dysphagia was reported by 32 (43.2%) patients, heartburn by 21 (28.4%), regurgitation by 7 (9.5%), and early satiety by 6 (8.1%). Regarding HRM findings, half of the patients (50%) exhibited normal manometry results. The most common abnormalities were ineffective esophageal motility (IEM) (16.2%), absent contractility (13.5%), and esophagogastric junction (EGJ) outflow obstruction (6.8%). MRS testing revealed that more than half of the patients (n = 43, 58.1%) demonstrated loss of esophageal PR (low, LPR, or absent, APR).Except for heartburn (p = 0.013), none of the other symptoms showed a significant association with abnormal manometry results (table 2). This pattern was also observed for manometry diagnoses. However, the analysis of MRS test alterations revealed a significant association between LPR and APR with dysphagia (p = 0.039). Composite analysis indicated that the combination of ineffective esophageal motility (IEM), absent contractility, or MRS alterations was strongly associated with dysphagia or heartburn (p < 0.001), as well as with esophagogastric symptoms overall (p = 0.013).Conclusions The study highlights the significant associations between esophageal manometry findings, peristaltic reserve, and esophagogastric symptoms in SSc patients. This suggests that the MRS test provided additional diagnostic value, particularly for evaluating peristaltic reserve and its relationship to dysphagia and heartburn, the most common symptoms reported by patients with SSc. Notably, some patients with normal manometry had loss of peristaltic reserve, emphasizing the importance of including MRS testing in the assessment. These findings underscore the importance of comprehensive HRM evaluation, including MRS, in the management of esophageal dysfunction in SSc patients.Abstract OC.47 Table 1Sociodemographic, clinical and manometry data in patients with systemic sclerosisAbstract OC.47 Table 2Association of manometry results with esophageal/gastric symptoms",
  "authors": [
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Carlos Gomes"
    },
    {
      "affiliations": [
        "Gastroenterology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Francisco Mendes"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Mariana Diz-Lopes"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Miguel Natal"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Bárbara Esteves"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Sara Lopes"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Ana Sá"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde de Viseu, Viseu, Portugal"
      ],
      "name": "Marina Oliveira"
    },
    {
      "affiliations": [
        "Rheumatology Department, Hospital Divino Espírito Santo, Ponta Delgada, Portugal"
      ],
      "name": "Mariana Sebastião"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Miguel Bernardes"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Lúcia Costa"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Raquel Ferriera"
    },
    {
      "affiliations": [
        "Rheumatology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Georgina Terroso"
    },
    {
      "affiliations": [
        "Gastroenterology Department, Unidade Local de Saúde De São João, Porto, Portugal"
      ],
      "name": "Armando Peixoto"
    }
  ],
  "title": "OC.47 Association between esophageal symptoms and high-resolution manometry findings: enhancing motility assessment with the multiple swallowing test",
  "uid": "57adc16d-fde9-559b-a94c-507d3c11415f"
}