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Scleroderma of the esophagus
Last reviewed: 23.04.2024
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Scleroderma of the esophagus - one of the manifestations of systemic scleroderma - a progressive disease characterized by changes in connective tissue with the development of sclerosis and obliterating lesions of arterioles. Systemic scleroderma is referred to the group of diffuse connective tissue diseases.
[Causes of esophageal scleroderma
In the etiology, genetic and infectious factors may be important. Provoke the disease cooling, trauma, foci of chronic infections, drug intolerance, endocrine changes (for example, after childbirth, in the climacteric period).
Pathomorphologic scleroderma of the esophagus is manifested by atrophy and sclerosis of the mucous membrane, as well as the appearance of ulcers.
The pathogenesis of the disease is complex and insufficiently studied. Great importance is attached to changes in the metabolism of calcium and connective tissue, immune and endocrine (hyperparathyroidism) disorders and lesions of the microcirculatory bed.
Symptoms of scleroderma of the esophagus
Women are more often sick in the age of 20-50 years. The disease usually develops gradually: there are vasomotor disorders according to the type of Raynaud's disease (symmetrical paroxysmal circulatory disturbances in the feet and hands with signs of secondary gangrene, occasionally similar vasomotor disorders are observed in the nose, ear, chin, capillaroscopy, long before the manifestation of the disease, narrowed capillaries and strongly curved capillary loops, mostly women suffer), arthralgia, dense skin swelling, later internal organs are affected. Approximately in the same period, there is a lesion of the gastrointestinal tract, mainly of the esophagus, which occurs in half the cases and is manifested by a violation of swallowing and heartburn.
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Treatment of esophageal scleroderma
Treatment of scleroderma of the esophagus is carried out for a long time, for years, mostly out-patient. Of the drugs used D-penicillamine, corticosteroids, derivatives of aminoquinoline (delagil n, etc.), vasodilators, non-steroidal anti-inflammatory drugs, drugs that improve microcirculation. Locally used dimethyl sulfoxide, hyaluronidase.
Prevention of exacerbations of systemic scleroderma consists in reasonable hardening of the organism, exclusion of provoking factors, systematic observation of patients for maintenance therapy.
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Prognosis of esophageal scleroderma
The prognosis for acute and subacute flow is more often unfavorable, with chronic - it improves depending on the quality and regularity of treatment, prevention of exacerbations.