Characteristics of Japanese patients with systemic sclerosis with dysphagia: a single-center study

Abstract To determine the prevalence of dysphagia and examine the association among dysphagia, components of gastrointestinal (GI) involvement and clinical features. Fifty consecutive patients with systemic sclerosis (SSc) examined by videofluoroscopic swallowing study were included. Dysphagia was identified by functional abnormalities such as aspiration and/or laryngeal penetration. Radiological findings such as the existence of residue was also evaluated. Esophageal involvement (E) and pharyngeal involvement (P) were defined by residue and gut involvement (G) was by the presence of diarrhea. Twenty-three patients (46%) had dysphagia. E was found in 96%, P in 82%, and G in 50%. Most of E had P (83%), and almost half of P had G (55%). All with G had E, and most of G was with P (88%). The E + P + G + group had younger onset, higher frequency with dysphagia, and higher UCLA GIT-2.0 compared with the E + P + group. Functional dysphagia was associated with radiological abnormalities such as pharyngeal and esophageal residue, diarrhea, and UCLA GIT-2.0 by multivariate analysis. Half of patients were affected by dysphagia. Pharyngeal involvement can be included in upper GI involvement. The emergence of pharyngeal involvement is an earlier stage than that of gut involvement, and patients with younger onset can have extended phenotype.