Esophageal motor disorders in subjects with incidentally discovered Chagas disease: a study using high-resolution manometry and the Chicago classification

Dis Esophagus. 2014 Aug;27(6):524-9. doi: 10.1111/j.1442-2050.2012.01438.x. Epub 2012 Oct 22.

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.

Keywords: Chagas disease; EJG outflow obstruction; esophagus; high-resolution manometry; hypocontractility.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Protozoan / blood*
  • Chagas Disease / blood
  • Chagas Disease / complications*
  • Chagas Disease / diagnosis
  • Esophageal Motility Disorders / classification
  • Esophageal Motility Disorders / diagnosis*
  • Esophageal Motility Disorders / parasitology
  • Esophageal Motility Disorders / physiopathology*
  • Esophageal Sphincter, Upper / physiopathology
  • Female
  • Humans
  • Incidental Findings
  • Male
  • Manometry*
  • Middle Aged
  • Pressure
  • Prospective Studies
  • Trypanosoma cruzi / immunology*
  • Young Adult

Substances

  • Antibodies, Protozoan