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

Authors

  • J. M. Remes-Troche,

    Corresponding author
    1. Digestive Physiology and Gastrointestinal Motility Laboratory, Medical-Biological Research Institute, Universidad Veracruzana, Veracruz, Mexico
    2. College of Medicine Miguel Alemán Valdés, Veracruz, Mexico
    • Address correspondence to: Dr José María Remes-Troche, MD, Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Iturbide SN, Colonia Flores Magón, CP 91400 Veracruz, Mexico. Email: joremes@uv.mx, jose.remes.troche@gmail.com

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  • M. Torres-Aguilera,

    1. Digestive Physiology and Gastrointestinal Motility Laboratory, Medical-Biological Research Institute, Universidad Veracruzana, Veracruz, Mexico
    2. College of Medicine Miguel Alemán Valdés, Veracruz, Mexico
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  • K. A. Antonio-Cruz,

    1. Digestive Physiology and Gastrointestinal Motility Laboratory, Medical-Biological Research Institute, Universidad Veracruzana, Veracruz, Mexico
    2. College of Medicine Miguel Alemán Valdés, Veracruz, Mexico
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  • G. Vazquez-Jimenez,

    1. Digestive Physiology and Gastrointestinal Motility Laboratory, Medical-Biological Research Institute, Universidad Veracruzana, Veracruz, Mexico
    2. College of Medicine Miguel Alemán Valdés, Veracruz, Mexico
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  • E. De-La-Cruz-Patiño

    1. Digestive Physiology and Gastrointestinal Motility Laboratory, Medical-Biological Research Institute, Universidad Veracruzana, Veracruz, Mexico
    2. College of Medicine Miguel Alemán Valdés, Veracruz, Mexico
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  • Authorship: José M Remes-Troche performed the research, analyzed the data, and wrote the paper; Maura Torres-Aguilera performed the research, Gustavo Vazquez-Jimenez and Eli de la Cruz Patiño performed esophageal high resolution manometry.
  • Funding: This research was supported by grant M0034- FOMIX VERACRUZ 68427 from the National Science and Technology Council (CONACYT).
  • Portions of this work were presented at the 2009 Digestive Diseases Week, Chicago, Illinois, USA and published as an abstract in Gastroenterology 2009, 136 (Suppl 5): A327.

Summary

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.

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