Comparação entre acalásia idiopática e acalásia conseqüente à doença de Chagas: revisão de publicações sobre o tema

Dantas, Roberto Oliveira

doi:10.1590/s0004-28032003000200012

Cited by 23 publications

(28 citation statements)

References 37 publications

(67 reference statements)

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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%

“…They exhibit neurodegeneration to a greater extent than other phenotypes, serotonergic interneurons or nitrergic inhibitory motor neurons (27) . The nitrergic inhibitory motor neurons (3) , and probably sensory neurons (9) , are affected by Chagas' disease. When a patient has megaesophagus the myenteric plexus is almost completely absent, but in patient with no dilatation the myenteric plexus destruction is only partial (15) .…”

Section: Discussionmentioning

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: Discussionmentioning

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 speed at which the disease progresses is variable (6,7) . In Brazil, Chagas disease is the main cause of achalasia, which affects 7-10% of individuals infected with T. cruzi (8) . In patients with Chagas disease-associated megaesophagus, the main presentation is involvement of the submucosal (Meissner) and myenteric (Auerbach) plexuses, impairment of 85% of their neurons having been demonstrated in some cases (3) .…”

Section: Discussionmentioning

confidence: 99%

Radiological findings in megaesophagus secondary to Chagas disease: chest X-ray and esophagogram

Abud

Abud²,

Vilar³

et al. 2016

Radiol Bras

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ObjectiveTo identify and classify the radiographic patterns of megaesophagus in Chagas disease, as seen on esophagograms and chest X-rays.Materials and MethodsThis was a prospective study of 35 patients diagnosed with esophageal disease via manometry. The changes found on esophagograms were stratified according to Rezende's classification, divided into four categories (grades I through IV) determined by the degree of dilatation and impairement of esophageal motility. We subsequently correlated that ranking with the chest X-ray findings: gastric air bubble; air-fluid level; and mediastinal widening.ResultsAmong the 35 patients, the esophageal disease was classified as grade I in 9 (25.7%), grade II in 3 (8.6%), grade III in 19 (54.3%), and grade IV in 4 (11.4%). None of the patients with grade I esophageal disease showed changes on chest X-rays. In two of the three patients with grade II disease, there was no gastric air-bubble, although there were no other findings in any of the grade II patients. Of the 19 patients with grade III disease, 15 had abnormal findings on X-rays. All four patients with grade IV disease showed abnormalities.ConclusionThe use of Rezende's classification is feasible, encompassing findings ranging from the subtle changes that characterize the initial phases of esophageal disease to the complete akinesia seen in dolicomegaesophagus. Chest X-ray findings are more common in patients with advanced stages of the disease and indicate the degree of esophageal involvement in Chagas disease.

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“…There is some difference in esophageal involvement between Chagas' disease and idiopathic achalasia (7) but there are no studies comparing proximal esophageal contraction in patients with vigorous or classic idiopathic achalasia. It is possible that patients with the classic disease have low contraction amplitude in the proximal esophagus.…”

Section: Discussionmentioning

confidence: 99%

Proximal and distal esophageal contractions in patients with vigorous or classic esophageal Chagas' disease

Dantas

Aprile

2005

Arq. Gastroenterol.

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-Background -Some patients with achalasia have distal esophageal contraction amplitude in the normal range, a condition called vigorous achalasia, and others have low contraction amplitude, a condition named classic achalasia. The difference in distal contraction amplitude may also be associated with a difference in proximal contraction amplitude. Aim -To study the proximal and distal esophageal contractions in patients with Chagas' disease. Material and Methods -We studied 28 patients with Chagas' disease, all with dysphagia and an esophageal radiologic examination with retention without dilation, and 18 controls. The patients with Chagas' disease had vigorous achalasia (distal amplitude over 34 mm Hg, n = 13) or classic achalasia (distal amplitude below 34 mm Hg, n = 15). We measured the contractions by the manometric method with continuous perfusion at 2, 7, 12 and 17 cm below the upper esophageal sphincter after five swallows of a 5 mL bolus of water. Results -There was no difference in proximal amplitude of contractions between classic or vigorous achalasia, and controls. In the proximal esophagus there was also no difference in duration or area under curve of contractions. In the distal esophagus, duration and area under curve were lower in classic than vigorous disease. Failed and simultaneous contractions were more frequent in patients than controls. Simultaneous contractions were seen more frequently in classic disease, and peristaltic contractions were seen more frequently in vigorous disease. Conclusion -We did not find differences in proximal esophageal contractions of patients with classical or vigorous esophageal Chagas' disease, except for the higher number of simultaneous contractions seen in classic disease.

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Comparação entre acalásia idiopática e acalásia conseqüente à doença de Chagas: revisão de publicações sobre o tema

Cited by 23 publications

References 37 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

Radiological findings in megaesophagus secondary to Chagas disease: chest X-ray and esophagogram

Proximal and distal esophageal contractions in patients with vigorous or classic esophageal Chagas' disease

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