Decreased tone of the lower esophageal sphincter is one of the symptoms of scleroderma esophagus, a connective tissue disease that affects the fibrous tissue and small blood vessels of several organs. When the esophagus is involved, it leads to esophageal smooth muscle spasm and ischemia, as well as smooth muscle atrophy and submucosal collagen deposition and fibrosis formation. Raynaud’s phenomenon is often an early manifestation of PSS, and the sites of capillary dilatation seen in PSS are usually the sites of predilection for Raynaud’s phenomenon, namely the face, tongue, lips, hands, and upper chest. In scleroderma, 95% of patients have Raynaud’s phenomenon, and 75% of them have Raynaud’s phenomenon as the first symptom. These patients often have visceral damage, and the prognosis and final outcome of scleroderma depends largely on the extent and severity of vascular damage. The esophageal body and lower esophageal sphincter show abnormalities on esophageal manometry, and progressive involvement is seen as a decrease in esophageal contraction length, partial peristaltic arrest of the smooth muscle of the esophageal body, and decreased tone of the lower esophageal sphincter, which is typical in patients with esophageal involvement in scleroderma. 1, Scleroderma combined with typical esophageal involvement patients can be seen on chest radiographs filled with air esophageal image of the lower esophageal sphincter of relaxation can not be closed. A barium meal further demonstrates loss of normal esophageal motility with an open or even complete lack of primary peristalsis in the flaccid esophagus and lower esophageal sphincter and may also provide evidence of esophagitis or stricture. 3. Radionuclide transfer tests to detect esophageal motility also correlate well with esophageal manometry in scleroderma. Esophageal 24h pH monitoring: Using the pH gradient method, the lower electrode of the pH monitor lead is placed at 5cm from the upper edge of the lower esophageal sphincter and the upper electrode of the lead is placed at 20cm from the upper edge of the lower esophageal sphincter, and the changes in esophageal pH are recorded continuously for 10, 12 and 24 h to understand the acidity of the esophagus. The general monitoring time is 18h or more. It is used in patients suspected of having reflux esophagitis. Esophageal manometry: Esophageal manometry provides an understanding of the motility of the esophagus, which often presents with a mismatch of esophageal motility coordination in esophagitis.