[Gastrointestinal motility disturbances in Chagas disease].
Serum antibodies against Trypanosoma Cruzi have been observed in 19% of the Chilean population. Marked differences in organ involvement have been reported in patients with Chagas disease. Chagas disease is rarely an aetiological factor for achalasia in Chile, which is different from reports in other countries of South America. In contrast, a high incidence of megacolon among these patients have been reported.


OBJECTIVE
To study the incidence of gastric and small intestinal motor disorders among these patients and their relationship to esophageal and colon motility disorders.


METHODS
We studied 18 patients, 12 women (mean age 45 years); with positive antibodies against T. Cruzi. Seven had radiological evidence of megacolon and no one had radiological or manometric evidence for achalasia. Non specific motor esophageal abnormalities were found in 11 patients. Nine had an abnormal electrocardiogram, suggesting a myocardial disease. A questionnaire for gastrointestinal symptoms, an electrogastrography and a small intestinal motility study, were performed in each patient.


RESULTS
All patients had evidences of abnormalities in at least one segment of the digestive tract. Twelve patients had an abnormal electrogastrographic study, with bradygastria as the most common finding. Nine had an abnormal small intestinal manometry with a myophatic pattern evidenced by a decreased amplitude of contractions (18.5 +/- 3 mmHg). Also an increased number of clustered contractions was observed.


CONCLUSIONS
Gastric dysrhythmias and small intestinal motor abnormalities are frequently associated to non specific esophageal motor disorders and megacolon in patients with Chagas disease.
Servicio de Medicina, Sección de Gastroenterología, Hospital Clínico de la Universidad de Chile, Santiago, Chile. amadrid@ns.hospital.uchile.cl
Ana María
AM
Madrid
Rodrigo
R
Quera
Carlos
C
Defilippi
Claudia
C
Defilippi
Luis C
LC
Gil
Jorge
J
Sapunar
Ana
A
Henríquez
D000293:Adolescent; D000328:Adult; D000368:Aged; D002598:Chagas Cardiomyopathy / Q000503:physiopathology; D014355:Chagas Disease / Q000503:physiopathology*; D002677:Chile; D004931:Esophageal Achalasia / Q000503:physiopathology; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007421:Intestine, Small / Q000502:physiology; D008297:Male; D008531:Megacolon / Q000503:physiopathology; D008875:Middle Aged