{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:10:47Z","timestamp":1791259847816,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,6]],"date-time":"2017-11-06T00:00:00Z","timestamp":1509926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007197","name":"U.S. Public Health Service","doi-asserted-by":"publisher","award":["K23 AR059763"],"award-info":[{"award-number":["K23 AR059763"]}],"id":[{"id":"10.13039\/100007197","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007197","name":"U.S. Public Health Service","doi-asserted-by":"publisher","award":["L30 AR054311"],"award-info":[{"award-number":["L30 AR054311"]}],"id":[{"id":"10.13039\/100007197","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001845","name":"Scleroderma Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001845","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Esophageal dysfunction and gastro\u2010esophageal reflux disease (GERD<\/jats:styled-content>) are common among patients with systemic sclerosis (SS<\/jats:styled-content>c). Although high\u2010dose proton pump inhibitors (PPI<\/jats:styled-content>s) typically normalize esophageal acid exposure, the effectiveness of PPI<\/jats:styled-content> therapy has not been systematically studied in SS<\/jats:styled-content>c patients. The aim of this study was to characterize reflux in SS<\/jats:styled-content>c patients on high\u2010dose PPI<\/jats:styled-content> using esophageal pH\u2010impedance testing.<\/jats:p><\/jats:sec>Methods<\/jats:title>In this case\u2010controlled retrospective analysis, 38 patients fulfilling 2013 American College of Rheumatology SS<\/jats:styled-content>c criteria who underwent esophageal pH\u2010impedance testing on twice\u2010daily PPI<\/jats:styled-content> between January 2014 and March 2017 at a tertiary referral center were compared with a control\u2010cohort of 38 non\u2010SS<\/jats:styled-content>c patients matched for PPI<\/jats:styled-content> formulation and dose, hiatal hernia size, age, and gender. Patient clinical characteristics, including endoscopy and high\u2010resolution manometry findings, were assessed via chart review.<\/jats:p><\/jats:sec>Key Results<\/jats:title>On pH\u2010impedance, SS<\/jats:styled-content>c patients had higher acid exposure times (AET<\/jats:styled-content>s) than controls. Sixty\u2010one percent of the SS<\/jats:styled-content>c patients and 18% of the control patients had a total AET<\/jats:styled-content> \u22654.5% (P<\/jats:italic>\u00a0<\u00a0.001). Systemic sclerosis patients also had significantly longer AET<\/jats:styled-content>s, longer median bolus clearance, and lower nocturnal impedance values.<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>Abnormal esophageal acid exposure despite high\u2010dose PPI<\/jats:styled-content> therapy was common among patients with SS<\/jats:styled-content>c. The lack of increased reflux episodes in the SS<\/jats:styled-content>c patients, and longer bolus clearance times and lower nocturnal impedance, supports ineffective clearance as the potential mechanism. Systemic sclerosis patients may require adjunctive therapies to PPI<\/jats:styled-content>s to control acid reflux.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13247","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T02:46:39Z","timestamp":1510022799000},"source":"Crossref","is-referenced-by-count":34,"title":["Abnormal esophageal acid exposure on high\u2010dose proton pump inhibitor therapy is common in systemic sclerosis patients"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0896-2522","authenticated-orcid":false,"given":"E. K.","family":"Stern","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-7758","authenticated-orcid":false,"given":"D. A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Falmagne","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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