![]() Its global prevalence is estimated to be around 1 in 10000 people, whereas the estimated annual incidence is of less than 00 individuals, both in Europe and in the United States. Systemic sclerosis (SSc) is an uncommon immune-mediated multisystemic disease that leads to a significant reduction in patient quality of life and has a high mortality rate. The role of surgical treatment is restricted and should only be preserved for resistant cases. Gastroesophageal reflux disease symptoms in patients with SSc are frequently difficult to manage, and new therapeutic modalities are emerging. Proton pump inhibitors remain the mainstay of treatment, while prokinetic agents are commonly used as add-on therapy in patients with symptoms attributed to gastroesophageal reflux disease not responding to standard therapy as well as to motility disturbances. Further exploration can be made by high resolution manometry and pH-impedance study. No formed guidelines exist about the diagnostic modalities used to assess esophageal disease in patients with SSc, though upper gastrointestinal endoscopy is the first and most important modality used as it can reveal alterations commonly observed in patients with SSc. Compelling evidence has correlated esophageal involvement to the severity of pulmonary disease. Symptoms are mainly attributed to gastroesophageal reflux disease and to esophageal dysmotility. Ultimately, esophageal smooth muscle becomes atrophied and replaced by fibrous tissue leading to severe motility disturbance of the distal esophagus. The exact pathophysiology is complex and not yet fully elucidated. Esophageal involvement may lead to a significant reduction in patient quality of life. The esophagus is the most commonly affected part of the gastrointestinal system in patients with systemic sclerosis (SSc).
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