Relationship of gastroesophageal reflux in patients systemic sclerosis with disease activity and severity, impact on quality of life

Introduction: Systemic sclerosis (SSc) is a chronic systemic disease characterized by vascular dysfunction and progressive fibrosis of the skin and internal organs. The gastrointestinal tract (GIS) is the most common target of SSc after the skin, and is involved in more than 90% of patients. In our study, we investigated whether there is a relationship between gastroesophageal reflux (GER) and quality of life, disease activity and severity in patients with systemic sclerosis (SSc). Materials and Methods: Fifty patients with systemic sclerosis who applied to Manisa Celal Bayar University Hospital Rheumatology Outpatient Clinic were included in the study. NIH PROMIS GERD (National Institutes of Health (NIH) patient-reported outcomes measurement information system (PROMIS®) Turkish questionnaire) was used to assess GER, and the Short Form-36 (SF-36) questionnaire was used to measure quality of life. The skin involvement was assessed with the ―Modified Rodnan Skin Score. The disease activity was determined the European Scleroderma Study Group (EScSG) activity index, and severity was determined by scoring system developed by Medsger et al. The relationship between reflux and quality of life, disease activity and severity scales were investigated. Conclusion: A total of 50 SSc patients, 46 women (92%) and a median age of 54.5 years (27-75 years), were included in the study. According to the NIH PROMIS GERD Turkish questionnaire, moderate to severe GER was detected in 70% of the patients (≥8 points). The mRDS score, which indicates skin sclerosis, was significantly higher in patients with GER (p=0.050). There was no relationship between disease activity and severity and GER. The subscales of quality of life including (physical) (|r|= -0.450), pain (|r|= -0.622), general health (|r|= -0.415), vitality (energy) (|r| = -0.303), physical function (|r|= -0.376), role difficulty (emotional) (|r|= -0.411) and mental health (|r|= - 0.388) were correlated with GER severity (p<0.005). Results: In our study, it was shown that quality of life was significantly reduced in SSc patients with severe GER. Key words: Systemic sclerosis, reflux, SF-36, NIH PROMIS GERD Turkish questionnaire