Esophageal contractions in Chagas' disease and in idiopathic achalasia.
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.
Dantas
Roberto Oliveira
RO
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
Aprile
Lilian Rose Otoboni
LR
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