title: Esophageal contractions in Chagas' disease and in idiopathic achalasia.
abstract: OBJECTIVE
  The aim of this study was to compare the esophageal contractions in Chagas' disease and in idiopathic achalasia.
  
  
  BACKGROUND
  It is suggested that the esophageal involvement caused by Chagas' disease and by idiopathic achalasia, although similar, shows some differences.
  
  
  METHODS
  We studied the contractions at 2, 7, 12, and 17 cm below the upper esophageal sphincter in 25 patients with idiopathic achalasia (15 with dilatation), 52 with Chagas' disease (22 with dilatation), and 18 controls. Each subject performed 5 swallows of a 5-mL bolus of water alternated with 5 dry swallows.
  
  
  RESULTS
  In the distal esophageal body, the amplitude was lower in patients than in controls. Among patients with esophageal dilatation, the proximal amplitude was lower in patients with idiopathic achalasia, and the time interval between the contractions at 2 and 7 cm was longer in patients with Chagas' disease, the number of failed contractions was higher in Chagas' disease, and simultaneous contractions were more frequent in idiopathic achalasia. The simultaneous isobaric pressure in the distal esophagus was associated with an increase in proximal pressure that was higher than distal but lower than proximal swallowing pressure.
  
  
  CONCLUSIONS
  The results suggested that idiopathic achalasia and Chagas' disease cause similar impairment of distal esophageal motility, but in patients with esophageal dilatation the impairment of proximal motility may be not the same.
authors.affiliation: Departamento de Clínica Médica, Faculdade de Medicina, Ribeirão Preto da Universidade de São Paulo, 14049-900 Ribeirão Preto, São Paulo, Brazil. rodantas@fmrp.usp.br
authors.forename: Roberto Oliveira
authors.initials: RO
authors.lastname: Dantas
authors.forename: Lilian Rose Otoboni
authors.initials: LR
authors.lastname: Aprile
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D014355:Chagas Disease / Q000473:pathology / Q000503:physiopathology*; D003679:Deglutition; D004108:Dilatation, Pathologic / Q000150:complications; D004931:Esophageal Achalasia / Q000473:pathology / Q000503:physiopathology*; D049631:Esophageal Sphincter, Upper / Q000473:pathology / Q000503:physiopathology*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009119:Muscle Contraction