Lower esophageal sphincter pressure in Chagas' disease

Dantas, Roberto Oliveira; Godoy, Renato Alves de; Oliveira, Ricardo Brandt de; Meneghelli, U. G.; Troncon, L E A

doi:10.1007/bf01536927

Cited by 28 publications

(22 citation statements)

References 28 publications

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“…Manometry was performed as described previously [8,10,11] with a four-lumen, polyvinyl, manometric catheter 5 mm in outer diameter and 1 mm in inner diameter. The lumens opened with side holes of 1 mm with a radial orientation, spaced 20, 18, 15, and 10 cm from the distal end of the catheter, which was infused with water at a rate of 1.7 ml/min through each lumen using a pneumohydraulic infusion system.…”

Section: Methodsmentioning

confidence: 99%

“…The LES pressure was measured by the station pull-through technique. The highest pressure measured at end expiration by one of the side holes represented the LES pressure for each subject [10]. The end-expiratory intragastric pressure was measured as reference for LES pressure, and the intraesophageal expiratory pressure was the reference for esophageal contraction amplitude.…”

Section: Methodsmentioning

confidence: 99%

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Dysphagia in Patients with Chagas' Disease

Dantas

1998

Dysphagia

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Some patients with Chagas' disease and apparent normal esophageal function complain of dysphagia. With the objective of investigating the esophageal motility of these patients we studied the esophageal contraction amplitude, duration, velocity, and lower esophageal sphincter (LES) pressure of 34 patients with a positive serologic test for Chagas' disease, normal radiologic esophageal examination, peristaltic contractions in the esophageal body, and complete LES relaxation. Fourteen patients complained of dysphagia and 20 had no symptoms. The results were compared with those of 22 healthy controls. We used the manometric method with continuous perfusion. In patients without dysphagia, the LES pressure (17.8 +/- 1.2 mmHg, mean +/- SEM) and distal esophageal amplitude (71.8 +/- 7.9 mmHg) were lower than those of control subjects (24.3 +/- 1.8 mmHg and 100. 4 +/- 10.6 mmHg, respectively). The velocity of peristaltic contractions was higher in patients than in controls, but there was no difference between patients with or without dysphagia. The duration of contraction in the distal esophagus was longer in patients with dysphagia (3.9 +/- 0.2 sec) than in patients without dysphagia (3.1 +/- 0.2 sec) and controls (3.2 +/- 0.2 sec). We conclude that dysphagia in patients with Chagas' disease and a nondilated esophagus with peristaltic contractions and complete LES relaxation is related to a longer duration of contractions in the middle and distal esophageal body.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Dysphagia in Patients with Chagas' Disease

Dantas

1998

Dysphagia

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“…Consequently lower esophageal sphincter pressure is frequently increased in idiopathic achalasia [14][15][16][17] and frequently decreased in Chagas' disease [16][17][18][19] which may explain the variation in the lower esophageal sphincter pressure [20] , and the heterogeneity seen in these patients [21] .…”

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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“…Dantas não encontrou diferença na média de pressão do EIE em relação aos resultados dos exames radiológico, manométrico e endoscópico do esôfago, bem como às queixa de disfagia e regurgitação 4 . Em estudos anteriores, Dantas observou que a média de pressão dos pacientes chagásicos estudados foi inferior à pressão de controles 6 , entretanto a diminuição da pressão do EIE na doença de Chagas não é observada por todos os autores que estudam o assunto 10 12 . Em nosso estudo, assim como Dantas, não observamos diferença estatisticamente significante da média da pressão do EIE em relação ao grau de megaesôfago dos pacientes estudados (grau I/II -20,7mmHg; grau III -22mmHg; grau IV-22,2mmHg)…”

Section: Discussionunclassified

Correlação manométrico-radiológica e sua importância no tratamento cirúrgico do megaesôfago chagásico

Crema

Cruvinel

Werneck

et al. 2003

Rev. Soc. Bras. Med. Trop.

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Resumo Foram analisados os achados radiológicos e manométricos de 43 pacientes portadores de megaesôfago chagásico com sorologia positiva para doença de Chagas. Encontrou-se uma redução significante dos valores da pressão máxima do corpo do esôfago com relação ao estádio da esofagopatia: grau I/II -42,9mmHg; grau III -23,6mmHg; grau IV -15,6mmHg. Observou-se que cinco (35,7%) pacientes classificados como grau III, do ponto de vista radiológico, apresentaram valores da pressão máxima do corpo do esôfago inferiores a 20mmHg, sendo considerados portadores de megaesôfago avançado, devendo ser tratados por esofagectomia subtotal com esofagogastroplastia ao invés de cardiomiotomia com válvula anti-refluxo. Constatou-se que o estudo manométrico é útil em pacientes portadores de megaesôfago grau III para a escolha do melhor procedimento cirúrgico. Palavras-chaves: Doença de Chagas. Megaesôfago. Eletromanometria. Estudo radiológico.Abstract This study analyzed the radiologic and manometric findings of 43 patients suffering from chagasic megaesophagus with positive tests for Chagas' disease. There was a significant reduction in the high pressure levels of the body of the esophagus related to the stage of the disease: stage I/II -42.9 mmHg; stage III -23.6 mmHg; stage IV -15.6 mmHg. It was observed that 5 (35.7%) stage III patients had high pressure levels below 20 mmHg and presented advanced megaesophagus and these underwent a subtotal esophagectomy following esophagogastroplasty instead of cardiomyotomy with anti-reflux valve. The manometric study in stage III patients with chagasic megaesophagus was considered helpful to indicate which surgical procedure would be best for these patients. Key-words: Chagas' disease. Megaesophagus. Electromanometry. Radiologic method. . A manifestação clínica inicial quase sempre é representada pela disfagia, podendo associar-se a dor epigástrica ou retroesternal., regurgitação, soluço, ptialismo e hipertrofia das glândulas salivares, notadamente das parótidas. Tosse e sufocação noturna podem estar presentes causadas por a broncoaspiração de alimentos regurgitados.A variabilidade do comprometimento esofagiano na doença de Chagas expressa-se no estudo radiológico, por meio do qual é possível distinguir vários estádios da afecção.

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Lower esophageal sphincter pressure in Chagas' disease

Cited by 28 publications

References 28 publications

Dysphagia in Patients with Chagas' Disease

Dysphagia in Patients with Chagas' Disease

Differences between idiopathic and chagasic achalasia

Correlação manométrico-radiológica e sua importância no tratamento cirúrgico do megaesôfago chagásico

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