Differences in response of the proximal esophagus to wet swallows in patients of Chagas’ disease and idiopathic achalasia

Ramos, Rosa; Varrica, Liliana Monastra; Dantas, Roberto Oliveira

doi:10.1111/j.1442-2050.2006.00601.x

Cited by 11 publications

(18 citation statements)

References 24 publications

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“…The physiological system that controls esophageal contraction can function with some variability that does not cause symptoms. The amplitude and duration of contractions observed here in the proximal esophageal body were similar to our previous results obtained with normal volunteers (7,8,20) . The importance of the knowledge of these differences is to understand the possibility of different behaviours during drinking and eating and in the recovery from diseases which cause dysphagia.…”

Section: -Out/dez 2009supporting

confidence: 80%

Gender differences in proximal esophageal contractions

Dantas

Alves

Cassiani

2009

Arq. Gastroenterol.

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-Context -There are reports showing that gender has an influence on swallowing and on the contractions of the distal esophageal body. Objective -In this investigation we studied the effect of gender on proximal esophageal contraction. Methods -We studied 20 men (22-68 years old, median 39 years) and 44 women (18-61 years old, median 41 years) without symptoms and without gastrointestinal or respiratory diseases. We measured the time interval between the onset of pharyngeal contraction 1 cm proximal to the upper esophageal sphincter and the onset of the proximal esophageal contraction 5 cm from the pharyngeal recording. We also measured the amplitude, duration and area under the curve of the proximal esophageal contractions. The recording was performed by the manometric method with continuous perfusion. The contractions were recorded in duplicate after swallows of a 5 mL bolus of water. Results -There were no differences between men and women in the interval between the onset of pharyngeal and of esophageal contractions or in the amplitude of esophageal contractions. The duration of contractions was longer in women (2.35 ± 0.60 s) than in men (2.07 ± 0.62 s) but the difference did not reach statistical significance (P = 0.087). The area under the curve of the esophageal contraction was higher in women (130.2 ± 55.2 mm Hg x s) than in men (97.4 ± 49.4 mm Hg x s, P = 0.026). Conclusion -We conclude that there is a difference between men and women in the proximal esophageal contractions in response to wet swallows, although this difference is of no clinical relevance.

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Section: -Out/dez 2009supporting

confidence: 80%

Gender differences in proximal esophageal contractions

Dantas

Alves

Cassiani

2009

Arq. Gastroenterol.

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“…In an investigation of the esophageal response to liquid swallows using the manometric method, we observed an increase in the time interval between the onset of pharyngeal contraction and the onset of the response of the proximal esophagus in chagasic patients compared to controls [11,12], showing a longer response latency of the proximal esophagus after swallowing. These patients take a longer time to ingest a liquid bolus [12].…”

Section: Discussionmentioning

confidence: 90%

Videofluoroscopic Evaluation of Swallowing in Chagas’ Disease

2011

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Dysphagia is the most common digestive symptom reported by patients with Chagas' disease. The condition results from abnormalities of esophageal motility. Our hypothesis is that there are also alterations of oral and pharyngeal transit during swallowing. We studied by videofluoroscopy the oral and pharyngeal transit during swallowing in 17 patients with dysphagia, a positive serologic test for Chagas' disease, and radiologic demonstration of esophageal involvement. The study also included 15 asymptomatic healthy volunteers. Each subject swallowed in duplicate 5 and 10 ml of liquid and paste barium boluses. Chagas' disease patients had a longer oropharyngeal transit with the 5-ml liquid bolus (p = 0.03), and a longer oral transit (p = 0.01) and pharyngeal transit (p = 0.04) with the 10-ml liquid bolus than controls. There was no difference between patients and controls with swallows of the 5-ml paste bolus. With swallows of the 10-ml paste bolus, the oropharyngeal transit (p = 0.05), pharyngeal transit (p = 0.04), pharyngeal clearance (p = 0.02), and UES opening (p = 0.01) took a longer amount of time in Chagas' disease patients than in controls. We conclude that the duration of pharyngeal transit is longer in patients with Chagas' disease than in normal subjects, especially with a bolus of pasty consistency and a volume of 10 ml.

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“…Although studies on idiopathic achalasia have demonstrated a partial opening of the upper esophageal sphincter with increased residual pressure during swallow [23] , these features have not been fully demonstrated in Chagas' disease [12,13] . The time between pharyngeal contraction and proximal esophageal contraction (5 cm distance) after wet swallows in patients with megaesophagus is increased in Chagas' disease but not in idiopathic achalasia [24] . Contractions in the esophageal body are not of the same intensity, and tend to be more intense in patients with idiopathic achalasia [19,25] .…”

Section: Differences Between Idiopathic and Chagas' Disease Achalasiamentioning

confidence: 99%

Differences between idiopathic and chagasic achalasia

Dantas¹

2017

MIS

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Idiopathic and Chagas' disease achalasia are characterized by absent or partial lower esophageal sphincter relaxation, absence of peristaltic esophageal contraction, food retenction in the esophagus and esophageal dilatation. The most frequent symptoms are dysphagia, regurgitation, heartburn, weight loss and non-cardiac chest pain. The diagnosis is made by radiologic examination and esophageal manometry, which is considered the most accurate exam to characterized achalasia. In both diseases there is destruction of the esophageal myenteric plexus. Despite similarities in clinical and manometric presentation there is evidence of greater loss of inhibitory neurons of the myenteric plexus in idiopathic achalasia, whereas in Chagas' disease there is a loss of both excitatory and inhibitory neurons. Such differences, though do not affect patients' clinical presentation, and hence treatment options should be the same for both diseases. Key words:Achalasia, Chagas' disease, megaesophagus, dysphagia, esophageal denervation ABSTRACTArticle history:

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Differences in response of the proximal esophagus to wet swallows in patients of Chagas’ disease and idiopathic achalasia

Cited by 11 publications

References 24 publications

Gender differences in proximal esophageal contractions

Gender differences in proximal esophageal contractions

Videofluoroscopic Evaluation of Swallowing in Chagas’ Disease

Differences between idiopathic and chagasic achalasia

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