Characterization of digestive disorders of patients with chronic Chagas disease in Cochabamba, Bolivia

Abstract

BackgroundChagas disease (CD) is endemic in Latin America and particularly common in Bolivia, but there is little information on the characteristics of chronic digestive involvement.ObjectivesTo determine the prevalence and characterize digestive manifestations in chronic CD patients in Cochabamba, Bolivia.MethodsEighty-five T. cruzi-seropositive individuals with or without digestive symptoms (G1 group), and fifteen T. cruzi-seronegative patients with similar digestive symptoms to those seen in CD (G2 group) were included in the study. All patients underwent a detailed history including past medical history, epidemiological information, hygiene and dietary habits, a complete physical examination, two serological tests for T. cruzi, video endoscopy, barium swallow, and barium enema.FindingsWe observed digestive manifestations in T. cruzi seropositive and seronegative patients. Colonic manifestations were detected in both groups, highlighting the relevance of other confounder factors in the region. Constipation was present in 52.9% of G1 patients, 62.4% presented two or more upper digestive tract symptoms, and 5.9% of them presented esophageal manifestations. Helicobacter pylori infection was detected in 58.8% of G1 patients, and all patients presented gastritis on endoscopy.ConclusionsPrevalence of digestive involvement in CD patients is higher than expected. However, digestive symptoms are not always caused by T. cruzi infection and require differential diagnoses.

Characterization of Latin American migrants at risk for Trypanosoma cruzi infection in a non-endemic setting. Insights into initial evaluation of cardiac and digestive involvement

“…Regarding digestive involvement, dolichocolon was very frequent in patients with a barium enema performed. In agreement with previous work [10,49,50], dolichocolon was not considered as a digestive involvement for CD, thus the observed frequency of digestive involvement was relatively low. Furthermore, digestive involvement was only present in patients from southern countries of Latin America (Bolivia and Argentina).…”

Bowel Frequency and Symptoms of Constipation and Its Relation With the Level of Physical Activity in Patients With Chagas Disease

“…The SNE is located on the walls of the gastrointestinal tract and consists of about 100 million neurons, from the esophagus to the anus and has the function of integrating and coordinating the different visceral functions (24) . Auerbach's plexus is the structure most affected by the inflammatory process triggered by T. cruzi infection, as it is located in the viscera wall, causing a marked reduction in the number of nerve cells (25,26) . In the Chagas group, the number of more inactive individuals was higher, reaffirming the stigma of the disease (which has no cure, which can lead to death, especially if some physical effort, etc.)…”

Target product profile for a test for the early assessment of treatment efficacy in Chagas disease patients: An expert consensus

“…They suffer from the chronic determinate form. Chronic Chagas disease patients can also be classified based on the level of tissue damage (e.g., Kuschnir´s modified classification for cardiac damage or Ximenes and Rezende classifications for digestive damage) [24].…”