Duodenal Myoelectric Activity in Scleroderma

Publisher Website
Google Scholar
Abstract
To determine the pathogenesis of small-bowel motor dysfunction in scleroderma, myoelectric and pressure responses of the duodenum were recorded at rest and in response to the duodenal instillation of warm water and the injection of pentagastrin, secretin and cholecystokinin. Slow-wave frequency and propagation velocity were similar in controls and in patients with scleroderma. In controls, the rate of slow waves associated with spike bursts after duodenal instillation of water (mean ± S.E.) was 95.7 ± 4.8 per cent as compared to 20.1 ± 2.8 per cent in scleroderma (p<0.01). Secretin and pentagastrin but not cholecystokinin increased the percentage of slow waves associated with spike bursts in normal controls. Of patients with scleroderma, seven responded normally to secretin and pentagastrin whereas six showed no response. Those who did not respond had disease of longer duration, a dilated proximal duodenum and steatorrhea. These studies suggest that motor dysfunction of the small intestine in scleroderma may be a result of impaired activation by mechanical and hormonal stimuli. (N Engl J Med 289:1220–1223, 1973)