{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T01:41:11Z","timestamp":1766367671855,"version":"3.48.0"},"reference-count":15,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Scleroderma is an autoimmune disorder characterized by vasculopathy, progressive skin fibrosis, and dysfunction of internal organs. Esophageal involvement is seen in most scleroderma patients. There is no specific treatment for dysphagia caused by scleroderma. FLIP technology is a novel diagnostic and therapeutic modality to assess the tightness of esophageal sphincters and esophageal motility and also provide therapeutic dilation. We describe the case of a patient with scleroderma who presented with dysphagia. Upper endoscopy was unremarkable. Esophageal manometry revealed aperistalsis with normal upper and lower esophageal sphincter (LES) relaxation. Barium esophagram demonstrated poor esophageal motility and hold-up of the barium tablet at the gastroesophageal junction. EndoFLIP test during sedated upper endoscopy revealed normal LES distensibility and absent peristalsis of the esophageal body. Due to dysphagia, the LES was dilated with a 30\u2009mm EsoFLIP. A barium esophagram following the dilation revealed a significant reduction in esophageal body diameter, normalization of barium tablet transit, and symptomatic improvement in dysphagia. Our case is the first report of the use of EsoFLIP to help improve dysphagia in a scleroderma patient. It illustrates the importance of multi-modal functional testing in patients with dysphagia and suggests the utility of EsoFLIP in the treatment of dysphagia in these patients.<\/jats:p>","DOI":"10.1515\/med-2025-1273","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T13:18:51Z","timestamp":1758115131000},"source":"Crossref","is-referenced-by-count":0,"title":["EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation"],"prefix":"10.1515","volume":"20","author":[{"given":"Subhankar","family":"Chakraborty","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Nutrition, The Ohio State University , 395 W 12th Avenue , Columbus , Ohio, 43016 , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Yearsley","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Ohio State University , Columbus , Ohio , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"2025122201303473252_j_med-2025-1273_ref_001","doi-asserted-by":"crossref","unstructured":"Ahuja NK, Clarke JO. Scleroderma and the esophagus. Gastroenterol Clin North Am. 2021;50(4):905\u201318.","DOI":"10.1016\/j.gtc.2021.08.005"},{"key":"2025122201303473252_j_med-2025-1273_ref_002","doi-asserted-by":"crossref","unstructured":"Voulgaris TA, Karamanolis GP. Esophageal manifestation in patients with scleroderma. World J Clin Cases. 2021;9(20):5408\u201319.","DOI":"10.12998\/wjcc.v9.i20.5408"},{"key":"2025122201303473252_j_med-2025-1273_ref_003","doi-asserted-by":"crossref","unstructured":"Spandorfer A, Stuart K, Daboul J, Waidyaratne G, Chakraborty S. Dysphagia in the elderly, a tough issue to swallow. OBM Geriatr. 2025;09(02):309.","DOI":"10.21926\/obm.geriatr.2502309"},{"key":"2025122201303473252_j_med-2025-1273_ref_004","doi-asserted-by":"crossref","unstructured":"Goyal RK. EndoFLIP topography: Motor patterns in an obstructed esophagus. Gastroenterology. 2022;163(3):552\u20135.","DOI":"10.1053\/j.gastro.2022.05.034"},{"key":"2025122201303473252_j_med-2025-1273_ref_005","doi-asserted-by":"crossref","unstructured":"Villadsen GE, Storkholm J, Zachariae H, Hendel L, Bendtsen F, Gregersen H. Oesophageal pressure\u2013cross-sectional area distributions and secondary peristalsis in relation to subclassification of systemic sclerosis. Neurogastroenterol Motil. 2001;13(3):199\u2013210.","DOI":"10.1046\/j.1365-2982.2001.00259.x"},{"key":"2025122201303473252_j_med-2025-1273_ref_006","doi-asserted-by":"crossref","unstructured":"Hoskins B, Almazan E, Hohl B, Ng K. Esophageal dilation with EsoFLIP is faster than CRE balloon dilation combined with EndoFLIP in children. Surg Endosc. 2023;37(8):6308\u201314.","DOI":"10.1007\/s00464-023-10129-3"},{"key":"2025122201303473252_j_med-2025-1273_ref_007","doi-asserted-by":"crossref","unstructured":"Baumann AJ, Carlson DA. EsoFLIP for esophageal dilation: Proposed advantages. Curr Opin Gastroenterol. 2020;36(4):329\u201335.","DOI":"10.1097\/MOG.0000000000000639"},{"key":"2025122201303473252_j_med-2025-1273_ref_008","doi-asserted-by":"crossref","unstructured":"Cheah JX, Khanna D, McMahan ZH. Management of scleroderma gastrointestinal disease: Lights and shadows. J Scleroderma Relat Disord. 2022;7(2):85\u201397.","DOI":"10.1177\/23971983221086343"},{"key":"2025122201303473252_j_med-2025-1273_ref_009","doi-asserted-by":"crossref","unstructured":"Carlson DA, Prescott JE, Germond E, Brenner D, Carns M, Correia CS, et al. Heterogeneity of primary and secondary peristalsis in systemic sclerosis: A new model of \u201cscleroderma esophagus\u201d. Neurogastroenterol Motil. 2022;34(7):e14284.","DOI":"10.1111\/nmo.14284"},{"key":"2025122201303473252_j_med-2025-1273_ref_010","doi-asserted-by":"crossref","unstructured":"Denaxas K, Ladas SD, Karamanolis GP. Evaluation and management of esophageal manifestations in systemic sclerosis. Ann Gastroenterol. 2018;31(2):165\u201370.","DOI":"10.20524\/aog.2018.0228"},{"key":"2025122201303473252_j_med-2025-1273_ref_011","doi-asserted-by":"crossref","unstructured":"Gregersen H, Villadsen GE, Liao D. Mechanical characteristics of distension-evoked peristaltic contractions in the esophagus of systemic sclerosis patients. Dig Dis Sci. 2011;56(12):3559\u201368.","DOI":"10.1007\/s10620-011-1777-9"},{"key":"2025122201303473252_j_med-2025-1273_ref_012","doi-asserted-by":"crossref","unstructured":"Emmanuel A. Current management of the gastrointestinal complications of systemic sclerosis. Nat Rev Gastroenterol Hepatol. 2016;13(8):461\u201372.","DOI":"10.1038\/nrgastro.2016.99"},{"key":"2025122201303473252_j_med-2025-1273_ref_013","doi-asserted-by":"crossref","unstructured":"Desprez C, Roman S, Leroi AM, Gourcerol G. The use of impedance planimetry (endoscopic functional lumen imaging probe, EndoFLIP((R))) in the gastrointestinal tract: A systematic review. Neurogastroenterol Motil. 2020;32(9):e13980.","DOI":"10.1111\/nmo.13980"},{"key":"2025122201303473252_j_med-2025-1273_ref_014","doi-asserted-by":"crossref","unstructured":"Salaria SN, Abu Alfa AK, Cruise MW, Wood LD, Montgomery EA. Lichenoid esophagitis: clinicopathologic overlap with established esophageal lichen planus. Am J Surg Pathol. 2013;37(12):1889\u201394.","DOI":"10.1097\/PAS.0b013e31829dff19"},{"key":"2025122201303473252_j_med-2025-1273_ref_015","doi-asserted-by":"crossref","unstructured":"Hoversten P, Otaki F, Katzka DA. Course of esophageal candidiasis and outcomes of patients at a single center. Clin Gastroenterol Hepatol. 2019;17(1):200\u20132.e1.","DOI":"10.1016\/j.cgh.2018.04.035"}],"container-title":["Open Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2025-1273\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2025-1273\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T01:37:18Z","timestamp":1766367438000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2025-1273\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,1]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,9]]},"published-print":{"date-parts":[[2025,1,9]]}},"alternative-id":["10.1515\/med-2025-1273"],"URL":"https:\/\/doi.org\/10.1515\/med-2025-1273","relation":{},"ISSN":["2391-5463"],"issn-type":[{"type":"electronic","value":"2391-5463"}],"subject":[],"published":{"date-parts":[[2025,1,1]]},"article-number":"20251273"}}