EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
Abstract
Scleroderma is an autoimmune disorder characterized by vasculopathy, progressive skin fibrosis, and dysfunction of internal organs. Esophageal involvement is seen in most scleroderma patients. There is no specific treatment for dysphagia caused by scleroderma. FLIP technology is a novel diagnostic and therapeutic modality to assess the tightness of esophageal sphincters and esophageal motility and also provide therapeutic dilation. We describe the case of a patient with scleroderma who presented with dysphagia. Upper endoscopy was unremarkable. Esophageal manometry revealed aperistalsis with normal upper and lower esophageal sphincter (LES) relaxation. Barium esophagram demonstrated poor esophageal motility and hold-up of the barium tablet at the gastroesophageal junction. EndoFLIP test during sedated upper endoscopy revealed normal LES distensibility and absent peristalsis of the esophageal body. Due to dysphagia, the LES was dilated with a 30 mm EsoFLIP. A barium esophagram following the dilation revealed a significant reduction in esophageal body diameter, normalization of barium tablet transit, and symptomatic improvement in dysphagia. Our case is the first report of the use of EsoFLIP to help improve dysphagia in a scleroderma patient. It illustrates the importance of multi-modal functional testing in patients with dysphagia and suggests the utility of EsoFLIP in the treatment of dysphagia in these patients.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- The Prediction of the In Vitro Release Curves for PLGA-Based Drug Delivery Systems with Neural Networks
- Promising Ursolic Acid as a Novel Antituberculosis Agent: Current Progress and Challenges
- Proof of principle concept for the analysis and functional prediction of rare genetic variants in the CYP2C19 and CYP2D6 genes
- Fabrication, characterization, and docking studies of furosemide-loaded nanosponges using the emulsion solvent diffusion method
- The Effect of Concomitant Administration of Proton Pump Inhibitors on the Pharmacokinetics of CDK4/6 Inhibitors in Rats: Implications for the Evaluation of Hepatic and Transporter-Mediated Drug–Drug Interactions
- Mining the Metabolic Capacity of Clostridium sporogenes Aided by Machine Learning
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.