High Resolution Esophageal Manometry in Patients with Chagas Disease: A Cross-Sectional Evaluation

Autor: Sánchez-Montalvá, Adrián, Moris, Maria, Mego Silva, Marianela, Salvador, Fernando, Accarino, Ana María, Ramírez, Kathleen, Azpiroz Vidaur, Fernando, Ruiz-de-Leon, Antonio, Molina, Israel, Universitat Autònoma de Barcelona. Departament de Medicina
Rok vydání: 2016
Předmět:
Male
Gastroenterology
Cohort Studies
Laryngology
0302 clinical medicine
Epidemiology
Medicine and Health Sciences
High resolution manometry
Hypertonic
Protozoans
Trypanosoma Cruzi
lcsh:Public aspects of medicine
Physics
Classical Mechanics
Dysphagia
Middle Aged
Chemistry
Infectious Diseases
medicine.anatomical_structure
Barium
Physical Sciences
Cohort
Female
030211 gastroenterology & hepatology
Anatomy
medicine.symptom
Research Article
Neglected Tropical Diseases
Chemical Elements
Biotechnology
Cohort study
Adult
Chagas disease
Trypanosoma
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine
Catheters
lcsh:RC955-962
Manometry
030231 tropical medicine
Hypotonic
03 medical and health sciences
Esophagus
Osmotic Pressure
Internal medicine
Parasitic Diseases
Pressure
medicine
Humans
Tonicity
Chagas Disease
Protozoan Infections
business.industry
Organisms
Public Health
Environmental and Occupational Health
Biology and Life Sciences
Heartburn
lcsh:RA1-1270
Tropical Diseases
medicine.disease
Parasitic Protozoans
Gastrointestinal Tract
Cross-Sectional Studies
Otorhinolaryngology
Spain
Medical Devices and Equipment
business
Digestive System
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 10, Iss 2, p e0004416 (2016)
ISSN: 1935-2735
DOI: 10.1371/journal.pntd.0004416
Popis: Introduction Gastrointestinal involvement affects 30–40% of the patients with chronic Chagas disease. Esophageal symptoms appear once the structural damage is established. Little is known about the usefulness of high resolution manometry to early identification of esophageal involvement. Method We performed a cross-sectional study at the Vall d’Hebron University Hospital (Barcelona, Spain) between May 2011 and April 2012. Consecutive patients diagnosed with Chagas disease in the chronic phase were offered to participate. All patients underwent a structured questionnaire about digestive symptoms, a barium esophagogram (Rezende classification) and an esophageal high resolution manometry (HRM). A control group of patients with heartburn who underwent an esophageal HRM in our hospital was selected. Results 62 out of 73 patients that were included in the study fulfilled the study protocol. The median age of the Chagas disease group (CG) was 37 (IQR 32–45) years, and 42 (67.7%) patients were female. Twenty-seven (43.5%) patients had esophageal symptoms, heartburn being the most frequent. Esophagogram was abnormal in 5 (8.77%). The esophageal HRM in the CG showed a pathological motility pattern in 14 patients (22.6%). All of them had minor disorders of the peristalsis (13 with ineffective esophageal motility and 1 with fragmented peristalsis). Hypotonic lower esophageal sphincter was found more frequently in the CG than in the control group (21% vs 3.3%; p
Author Summary Chagas disease is a parasitic disease mainly transmitted to humans by blood-sucking insects. The disease was endemic in Latin America, but it is now a global disease due to migratory movements. The disease can affect the heart and the digestive system (mainly esophagus and colon). Classically, esophageal assessment in Chagas disease is performed by X-ray and self-reported symptoms. However, they lack accuracy and detect only advanced stage of the disease. Recently, new tools, such as esophageal high resolution manometry, provide more detailed information about the motility disorders of the esophagus. We assessed the esophageal involvement in patients with Chagas disease by means of high resolution manometry and compared the findings with the X-ray and self-reported symptoms. We found a low rate of mild severity motility disorders. We did not find an association between X-ray assessment and symptoms with the high resolution manometry findings. The assessment of esophageal involvement in patients with Chagas disease may benefit from early diagnosis by high resolution manometry, although more research is needed.
Databáze: OpenAIRE
Externí odkaz: