Digestive Disorders in Chagas Disease: Megaesophagus and Chagasic Megacolon

Abstract

Chagas disease, also known as American trypanosomiasis, caused by Trypanosoma cruzi and transmitted by hematophagous vectors, is a parasitic disease, which according to the WHO ranks fourth as a cause of loss of potential years of life due to complications that can occur in multiple body systems. According to the reports presented by the World Health Organization, there are between 16 and 18 million infected people in the world, predominantly in endemic areas of Latin America, of which only 1% receives an adequate diagnosis and full treatment, thereby that the chronic phase comes to present digestive disorders that are one of the main causes of loss in the quality of life of patients, as well as complications that can lead to life-threatening surgical emergencies.

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“…Meanwhile, other strains attack the digestive system and tend to reduce or destroy the neurons of the intramural nerve plexuses, leading to the elongation, dilation, and hypertrophy of a portion of the colon, leading to a clinical picture of chronic constipation [ 117 ]. Likewise, the esophagus can be affected (chagasic megaesophagus), which is manifested by the inability of the esophageal sphincter to relax in response to swallowing and the absence of peristalsis in the esophageal body [ 118 ]. Among the disorders that are potentially caused by T. cruzi , chagasic cardiomyopathy is the most severe and is associated with high mortality in Latin America [ 119 ].…”

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“…Megaesophagus (dilation of the esophagus, impaired peristalsis, and esophageal stasis) can be seen in the barium esophagram and the upper endoscopy. Megacolon (dilation of the colon, impaired peristalsis, fecaloma, and volvulus) can be spotted in the barium enema and lower endoscopy [14,18].…”