Background/Purpose: The Gastrointestinal tract (GI) is one of the most commonly affected systems in systemic sclerosis (SSc), impacting the lives of up to 90% of patients, irrespective of their disease subtype. Of the GI manifestations in SSc, GI dysmotility impacts as many as 90% of patients with SSc. Various GI modalities are used to assess and aid in the diagnosis of GI tract motility compromise. The wireless motility capsule (WMC) is an ambulatory, noninvasive and ingestible device that measures intraluminal pressure, pH, and temperature changes as it moves through the GI tract. This helps evaluate regional and whole gut transit times, as well as phasic GI motor activity.

Objective: To describe the regional and whole gut transit times in patients with SSc and to evaluate relationship between GI transit time and other organ manifestation in SSc disease.

Methods: This was a retrospective analysis of all SSc patients from the UCLA SSc program and the UCLA- database, meeting the 2013 ACR/EULAR SSc classification criteria, ≥ 18 y.o, and having had a WMC test performed from July 1, 2013 to July 1, 2016. We reported both regional (gastric emptying, small bowel, and colonic transit times) as well as whole gut transit times. We evaluated other rheumatologic manifestations, including: interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), creatinine clearance (CrCl), and diffuse vs. limited disease. Additionally, we reported patient-reported symptoms related to upper and lower GI transit, including GERD, heartburn, regurgitation, vomiting, dysphagia, constipation, and diarrhea. Statistical analyses of numerical variables were assessed using Wilcoxon rank sum tests and T-tests and categorical variables were assessed using Fisher’s exact tests.

Results: A total of 35 patients met our inclusion criteria. The median age was 57.5 years. There were 34 (97%) women; 23 (65%) were white/Caucasian; 28 (80%) were non-Hispanic/Latino; 25 (71.4%) had limited SSc; 22 (62.9%) had ILD; 16 (45.7%) had PAH. The mean CrCl was 78.1 with SD of 24.8. No statistically significant correlation was noted between regional and/or whole gut motility and other SSc organ manifestation. We found that 42.9% had decreased gastric emptying; 37.5% had decreased small bowel transit time; 33.3% had decreased colonic transit time.

Conclusion: In this small cohort, we did not find a significant correlation between regional and whole gut transit times and other manifestations of SSc. Interestingly, we found a discrepancy between patient-reported symptoms and WMC transit times, indicating that symptomatology may not be correlated with a decrease in regional GI transit times. A larger cohort study is needed to verify our findings.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/regional-and-whole-gut-transit-times-in-patients-with-systemic-sclerosis-using-the-wireless-motility-capsule/