Suprahyoid Muscle Activity in Patients with Chagasic Megaesophagus

Abstract

The objective of this investigation was to evaluate the activity of the suprahyoid musculature during swallowing and to correlate the findings with the degree of megaesophagus, oral and pharyngeal videofluoroscopy and esophageal manometry in patients with achalasia caused by Chagas’ disease. Twenty-nine patients with positive serology for Trypanosoma cruzi and dysphagia (Chagas’ disease group) and 29 individuals matched by sex and age (control group) participated in the study. Surface electromyography of the suprahyoid musculature and videofluoroscopy during swallowing of paste and liquid consistencies were performed. Canonical correlation analysis of the MANOVA test results showed that the Chagas’ disease group had lower electromyographic activity when compared with controls. Overlapping circles of radiological findings were found for megaesophagus. The Spearman test showed a positive correlation between the electromyographic activity in the maximum voluntary isometric contraction and the time of pharyngeal transit for both liquid (p = 0.014) and paste (p = 0.047). The logistic regression test showed no association between electromyographic activity of the suprahyoid muscles and esophageal manometry results (p > 0.05). In conclusion, individuals with chagasic megaesophagus have reduced electromyographic activity of the suprahyoid muscles during swallowing, in addition to a greater recruitment of the suprahyoid musculature with increased pharyngeal transit time.

Digestive Disorders in Chagas Disease: Megaesophagus and Chagasic Megacolon

“…Although any organ of the digestive system can be affected by Chagas disease, the esophagus and the colon are the ones that are most frequently damaged. The symptoms associated with Chagasic megaesophagus generally do not put the patient's pathway at risk, however, they considerably reduce their quality of life, since they generate eating disorders secondary to dysphagia, odynophagia, or esophageal insufficiency [16].…”

“…It has been observed that the contractile activity in the electromyography of patients with Chagas disease is lower than that of those who present motor esophageal disorders without this disease. This may be explained by decreased muscle recruitment of the suprahyoid muscles in patients with Chagasic megaesophagus and symptoms of dysphagia [16].…”