title: Esophageal motor disorders in subjects with incidentally discovered Chagas disease: a study using high-resolution manometry and the Chicago classification.
abstract: In patients with chronic indeterminate Chagas disease, conventional manometry has shown that 25-48% had esophageal motor disorders. Recently, esophageal high-resolution manometry (HRM) has revolutionized the assessment of esophageal motor function. In this study, we performed esophageal HRM in a group of subjects with incidentally positive serological findings for Trypanosoma cruzi. In this prospective observational study, we evaluated subjects who had positive serological tests for Chagas disease detected during a screening evaluation for blood donation. All subjects underwent symptomatic evaluation and esophageal HRM with a 36 solid-state catheter. Esophageal abnormalities were classified using the Chicago classification. Forty-two healthy subjects (38 males) aged 18-61 years (mean age, 40.7 years) were included. When specific symptoms questionnaire was applied, 14 (33%) subjects had esophageal symptoms. Esophageal high-resolution manometry revealed that 28 (66%) of the subjects had an esophageal motility disorder according to the Chicago classification. Most common findings were hypocontractile disorders in 18 subjects (43%) and esophagogastric junction (EGJ) outflow obstruction in 6 (15%). Esophageal high-resolution manometry reveals that up to two thirds of the subjects with an incidental diagnosis of Chagas disease have esophageal abnormalities. This technology increases the detection and allows a more complete assessment of esophageal motor function in subjects infected with T. cruzi even in the early stages of the disease.
authors.affiliation: Digestive Physiology and Gastrointestinal Motility Laboratory, Medical-Biological Research Institute, Universidad Veracruzana, Veracruz, Mexico; College of Medicine Miguel Alemán Valdés, Veracruz, Mexico.
authors.forename: J M
authors.initials: JM
authors.lastname: Remes-Troche
authors.forename: M
authors.initials: M
authors.lastname: Torres-Aguilera
authors.forename: K A
authors.initials: KA
authors.lastname: Antonio-Cruz
authors.forename: G
authors.initials: G
authors.lastname: Vazquez-Jimenez
authors.forename: E
authors.initials: E
authors.lastname: De-La-Cruz-Patiño
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood*; D014355:Chagas Disease / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D015154:Esophageal Motility Disorders / Q000145:classification / Q000175:diagnosis* / Q000469:parasitology / Q000503:physiopathology*; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D014349:Trypanosoma cruzi / Q000276:immunology*; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan
keywords: Chagas disease; EJG outflow obstruction; esophagus; high-resolution manometry; hypocontractility