Abstract
The endoscopic findings of reflux esophagitis were classified into two types (longitudinal and localized type) and five lesions (anterior, posterior, right side, left side, and circumferential lesion) on the basis of longitudinal and circumferential extent respectively in 24 progressive systemic sclerosis (PSS) patients and 26 hiatal hernia (H. H.) patients. Moreover, esophageal motility and salivary secretion were measured to clarify the patho-physiological correlation between the endoscopic findings, esophageal motility and secretory volume of the saliva. In the H. H. group, the incidence of longitudinal and localized type was same. In the PSS group, the incidence of localized type was higher (79.2%) than that of longitudinal type (p <0.05). In respect of circumferential extent of reflux esophagitis, the incidence of non-circumferential lesion was higher (79.2%) than that of circumferential lesion (20.8%) in the PSS group, whereas the incidence of circumferential lesion was higher (61.5%) than that of non-circumferential lesion (38.5%) in the H. H. group (x2-test, p<0.01). In the non-circumferential lesion, the incidence of right-posterior side lesion was higher than that of left-anterior side lesion in the PSS and the H. H. group. In the PSS group, significant correlation was not recognized between longitudial extent of reflux esophagitis and esophageal motility. Amplitude of primary peristalsis of lower esophagus in the right-posterior side lesion was lower than that in the left-anterior side lesion (p <0.05). Esophageal acid clearing time in the circumferential lesion was significantly longer than that in the non-circumferential lesion (p <0.01). Therefore, in the PSS group, correlation between circumferential extent of reflux esophagitis, and low amplitude of primary peristalsis and delayed acid clearance of esophagus were recognized. In the H. H. group, it was suggested that there was a correlation between longitudinal and circumferential extent of reflux esophagitis and decrease in salivary secretion.
