Dysphagia in Patients with Chagas' Disease

Dantas, Roberto Oliveira

doi:10.1007/pl00009549

Cited by 24 publications

(25 citation statements)

References 17 publications

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“…The lower amplitude of contractions, and the larger number of simultaneous and non-conducted contractions found here in patients with Chagas' disease compared to controls are in agreement with previous reports (1,3,4,5,22) . Older patients with Chagas' disease with clinical and radiologic examination similar to that of younger patients had a lower amplitude of contractions and more non-conducted contractions in the distal esophagus than younger patients, showing a decrease in the capacity of contractions in the distal esophagus of older patients compared to younger patients.…”

Section: Discussionsupporting

confidence: 93%

“…There is degeneration and reduction of the neurons of the myenteric plexus (15,16,22) causing esophageal motility abnormalities similar to those of idiopathic achalasia, absent or partial lower esophageal sphincter relaxation and loss of peristaltic contractions in the esophageal body (5,22) . Most patients do not have these advanced manifestations of the disease, but even patients without dysphagia and with a normal radiologic esophageal examination may have some motility alterations (1,4) . During the aging process there is a loss in the number of neurons in the gut myenteric plexus (16,19,27) .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of esophageal motility impairment caused by Chagas' disease in two age groups

Dantas

Aprile

2006

Arq. Gastroenterol.

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-Background -Chagas' disease and the aging process cause loss of neurons of the esophageal myenteric plexus.Aim -To evaluate the esophageal motility impairment caused by Chagas' disease in two age groups. Our hypothesis was that the aging process may cause further esophageal motility impairment in patients with Chagas' disease. Methods -We studied the esophageal motility of 30 patients with Chagas' disease and dysphagia, with esophageal retention of barium sulfate and an esophageal diameter within the normal range. Fifteen were 34 to 59 years old (younger group, median 51 years) and 15 were 61 to 77 years old (older group, median 66 years). As a control group we studied 15 subjects aged 33 to 58 years (median 42 years) and 7 subjects aged 61 to 73 years (median 66 years). The esophageal contractions were measured by the manometric method with continuous perfusion after fi ve swallows of a 5 mL bolus of water at 2, 7, 12 and 17 cm below the upper esophageal sphincter. Results -Patients with Chagas' disease had lower amplitude of contractions and fewer peristaltic, more simultaneous, and more non-conducted contractions than controls. Older patients with Chagas' disease had lower amplitude of contractions in the distal esophagus (mean ± SE: 30.8 ± 4.3 mm Hg) than younger patients (51.9 ± 8.6 mm Hg). From 12 to 17 cm, older patients had more non-conducted (41%) and fewer peristaltic (8%) contractions than younger patients (non-conducted: 16%, peristaltic: 21%). Conclusion -Older patients with Chagas' disease with clinical and radiological examinations similar to those of younger patients had motility alterations suggesting that the aging process may cause further deterioration of esophageal motility.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Comparison of esophageal motility impairment caused by Chagas' disease in two age groups

Dantas

Aprile

2006

Arq. Gastroenterol.

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“…The present results suggest that the duration of esophageal contraction may be increased in the middle esophagus with swallows of a solid bolus followed by perception of bolus transit, but the comparison with swallows that do not cause perception did not reach statistical significance. In a study of esophageal motility in patients with Chagas' disease, a disease consequent to the loss of neurons of the esophageal myenteric plexus (9) , an increase in esophageal contraction duration was found in patients with dysphagia, peristaltic esophageal contractions and normal esophageal radiologic transit (5) . In a group of patients with non-obstructive dysphagia, a variation of the causes of the sensation was described.…”

Section: Discussionmentioning

confidence: 99%

Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects

Dalmazo

Aprile

Dantas

2012

Arq. Gastroenterol.

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-Context -Esophageal dysphagia is the sensation that the ingested material has a slow transit or blockage in its normal passage to the stomach. It is not always associated with motility or transit alterations. Objectives -To evaluate in normal volunteers the possibility of perception of bolus transit through the esophagus after swallows of liquid and solid boluses, the differences in esophageal contraction and transit with these boluses, and the association of transit perception with alteration of esophageal contraction and/or transit. Methods -The investigation included 11 asymptomatic volunteers, 4 men and 7 women aged 19-58 years. The subjects were evaluated in the sitting position. They performed swallows of the same volume of liquid (isotonic drink) and solid (macaroni) boluses in a random order and in duplicate. After each swallow they were asked about the sensation of bolus passage through the esophagus. Contractions and transit were evaluated simultaneously by solid state manometry and impedance.Results -Perception of bolus transit occurred only with the solid bolus. The amplitude and area under the curve of contractions were higher with swallows of the solid bolus than with swallows of the liquid bolus. The difference was more evident in swallows with no perception of transit (n = 12) than in swallows with perception (n = 10). The total bolus transit time was longer for the solid bolus than for the liquid bolus only with swallows followed by no perception of transit. Conclusion -The results suggest that the perception of esophageal transit may be the consequence of inadequate adaptation of esophageal transit and contraction to the characteristics of the swallowed bolus.

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“…22 It is possible, however, that delayed gastric emptying was one factor contributing to the morbidity of our patients. Dysphagia, on the other hand, is directly associated with the presence of achalasia, 23 and the clinical histories thereof are longer in patients with greater esophageal dilatation, as in grades II and III. This fact suggests that the duration of relevant history is associated with the degree of esophageal dilatation found in such patients, but not with the observed gastric alterations.…”

Section: B Discussionmentioning

confidence: 99%

Delayed Gastric Emptying for Semi-Solid Diets in Patients With Chagasic Megaesophagus

Chinzon¹,

Navarro–Rodriguez²,

Dal-Paz³

et al. 2011

Gastroenterology

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OBJECTIVE:To measure the time to gastric emptying of a semi-solid diet in individuals with Chagasic megaesophagus, in comparison with a non-Chagasic control group. METHOD: The time to gastric emptying of a semi-solid diet was assessed via ultrasonography in 28 patients with Chagasic megaesophagus (grades I, II, and III) and compared to that of a control group (n ¼ 15). After measurement of antral diameter under fasting conditions, 400 mL of a semi-solid diet were administered and consecutive measurements were performed every 30 min. RESULTS: The duration of dysphagia was significantly lower in patients with megaesophagus grade I than in those with grades II or III. The time to gastric emptying was significantly increased in the megaesophagus group compared to the control group. The means of antral areas measured under fasting conditions and after maximal antral distension did not differ between the megaesophagus and control groups. CONCLUSION: The time to gastric emptying of a semi-solid diet was significantly greater in patients with Chagasic megaesophagus than in controls. The delay did not depend on the extent of dilatation of the megaesophagus or the duration of dysphagia.

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Dysphagia in Patients with Chagas' Disease

Cited by 24 publications

References 17 publications

Comparison of esophageal motility impairment caused by Chagas' disease in two age groups

Comparison of esophageal motility impairment caused by Chagas' disease in two age groups

Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects

Delayed Gastric Emptying for Semi-Solid Diets in Patients With Chagasic Megaesophagus

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