Prevalence and Risk Factors for Esophageal Strictures in Systemic Sclerosis
Files
(Published version)
Date
2026
Authors
Quinlivan, A.
Hansen, D.
Stevens, W.
Ferdowsi, N.
Proudman, S.
Walker, J.
Sahhar, J.
Ngian, G.
Apostolopoulos, D.
Host, L.V.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
ACR Open Rheumatology, 2026; 8(4):e90033-1-e90033-7
Statement of Responsibility
Alannah Quinlivan, Dylan Hansen, Wendy Stevens, Nava Ferdowsi, Susanna Proudman, Jennifer Walker, Joanne Sahhar, Gene-Siew Ngian, Diane Apostolopoulos, Lauren V. Host, Chamara Basnayake, Kathleen Morrisroe, Laura Ross and Mandana Nikpour
Conference Name
Abstract
Objective: Gastroesophageal reflux disease (GERD) affects up to 90% of patients with systemic sclerosis (SSc). Chronic esophageal acid exposure can result in complications including the formation of esophageal strictures (ES). Proton pump inhibitors can alter gastric acid pH and improve GORD symptoms; however, there have been no recent studies evaluating the prevalence of SSc–ES since these medications became widely available. Our aim was to investigate the prevalence of SSc–ES over time and identify risk factors associated with ES. Methods: Consecutive patients from the Australian Scleroderma Cohort Study who met American College of Rheumatology/ EULAR criteria for SSc were included. Clinically significant ES was defined as characteristic findings seen on gastroscopy or patient-reported ES requiring dilatation. Multivariable logistic regression analysis was used to identify factors associated with SSc–ES. The time to SSc–ES development from SSc disease onset was evaluated using Kaplan-Meier survival analysis. Results: ES affected 191 of 1,543 patients (12.4%) and were associated with a longer disease duration, gastric antral vascular ectasia, esophageal dysmotility, reflux esophagitis, and myocardial disease on multivariable logistic regression analysis (P < 0.05). Compared to patients with SSc diagnosed before 1990, those who were diagnosed between 2000 and 2010 and 2010 and 2023 were significantly less likely to have clinically significant ES on multivariable logistic regression analysis (odds ratio 0.45 and 0.42, respectively; P = 0.002).The median disease duration at time of SSc–ES diagnosis increased from 3 (interquartile range 0–5) years to 11.5 (interquartile range 3.5–24) years for those diagnosed with SSc–ES before 1990 to those diagnosed after 2010 (P = 0.0027). Conclusion: SSc–ES is associated with a longer disease duration and other gastrointestinal SSc manifestations, with prevalence decreasing over time.
School/Discipline
Dissertation Note
Provenance
Description
Access Status
Rights
© 2026 The Author(s). ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.