Volume 92, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The aim of this study was to determine the relationship between colonic symptoms, radiological abnormalities, and anorectal dysfunction in patients with Chagas disease. We performed a cross-sectional study of untreated patients diagnosed with Chagas disease. All patients were evaluated clinically (by a questionnaire for colonic symptoms based on Rome III criteria) and underwent a barium enema and anorectal manometry. A control group of patients with functional constipation and without Chagas disease was included in the study. Overall, 69 patients were included in the study: 42 patients were asymptomatic and 27 patients had abdominal symptoms according to Rome III criteria. Anorectal manometry showed a higher proportion of abnormalities in symptomatic patients than in asymptomatic ones (73% versus 21%, respectively; < 0.0001). Megarectum was detected in a similar proportion in the different subgroups regardless of the presence of symptoms or abnormalities in anorectal functions. Among non-Chagas disease patients with functional constipation, 90% had an abnormal anorectal manometry study. Patients with Chagas disease present a high proportion of constipation with dyssynergic defecation in anorectal manometry but a low prevalence of impaired rectoanal inhibitory reflex, although these abnormalities may be nonspecific for Chagas disease. The presence of megarectum is a nonspecific finding.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. World Health Organization, Chagas disease (American trypanosomiasis). Available at: http://www.who.int. Accessed August 1, 2014.
  2. Schmunis GA, Yadon ZE, , 2010. Chagas disease: a Latin American health problem becoming a world health problem. Acta Trop 115: 1421.[Crossref] [Google Scholar]
  3. Salvador F, Treviño B, Sulleiro E, Pou D, Sánchez-Montalvá A, Cabezos J, Soriano A, Serre N, Gómez i Prat J, Pahissa A, Molina I, , 2014. Trypanosoma cruzi infection in a non-endemic country: epidemiological and clinical profile. Clin Microbiol Infect 20: 706712.[Crossref] [Google Scholar]
  4. Pérez-Ayala A, Pérez-Molina J, Norman F, Navarro M, Monge-Maillo B, Díaz-Menéndez M, Peris-García J, Flores M, Cañavate C, López-Vélez R, , 2011. Chagas disease in Latin American migrants: a Spanish challenge. Clin Microbiol Infect 17: 11081113.[Crossref] [Google Scholar]
  5. Muñoz J, Gómez I, Prat J, Gállego M, Gimeno F, Treviño B, López-Chéjade P, Ribera O, Molina L, Sanz S, Pinazo MJ, Riera C, Posada EJ, Sanz G, Portús M, Gascón J, , 2009. Clinical profile of Trypanosoma cruzi infection in a non-endemic setting: immigration and Chagas disease in Barcelona (Spain). Acta Trop 111: 5155.[Crossref] [Google Scholar]
  6. Coura JR, Anunziato N, Willcox HP, , 1983. Chagas disease morbidity. I- Study of cases originating in various states of Brazil, observed in Rio de Janeiro. Mem Inst Oswaldo Cruz 78: 363372.[Crossref] [Google Scholar]
  7. Pless M, Juranek D, Kozarsky P, Steurer F, Tapia G, Bermudez H, , 1992. The epidemiology of Chagas' disease in a hyperendemic area of Cochabamba, Bolivia: a clinical study including electrocardiography, seroreactivity to Trypanosoma cruzi, xenodiagnosis, and domiciliary triatomine distribution. Am J Trop Med Hyg 47: 539546. [Google Scholar]
  8. Brenière SF, Carrasco R, Revollo S, Aparicio G, Desieux P, Tibayrenc M, , 1989. Chagas' disease in Bolivia: clinical and epidemiological features and zymodeme variability of Trypanosoma cruzi strains isolated from patients. Am J Trop Med Hyg 41: 521529. [Google Scholar]
  9. Sánchez-Guillén MC, López-Colombo A, Ordóñez-Toquero G, Gómez-Albino I, Ramos-Jiménez J, Torres-Rasgado E, Salgado-Rosas H, Romero-Díaz M, Pulido-Pérez P, Pérez-Fuentes R, , 2006. Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico. Mem Inst Oswaldo Cruz 101: 733740.[Crossref] [Google Scholar]
  10. Lescure FX, Le Loup G, Freilij H, Develoux M, Paris L, Brutus L, Pialoux G, , 2010. Chagas disease: changes in knowledge and management. Lancet Infect Dis 10: 556570.[Crossref] [Google Scholar]
  11. Riera C, Verges M, Iniesta L, Fisa R, Gállego M, Tebar S, Portús M, , 2012. Identification of a Western blot pattern for the specific diagnosis of Trypanosoma cruzi infection in human sera. Am J Trop Med Hyg 86: 412416.[Crossref] [Google Scholar]
  12. Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders. Available at: http://www.romecriteria.org/assets/pdf/19_RomeIII_apA_885-898.pdf. Accessed August 1, 2014. [Google Scholar]
  13. Ximenes CA, , 1984. Tecnica simplificada para o diagnóstico radiológico do megacolo chagásico. Rev Soc Bras Med Trop 17: 23. [Google Scholar]
  14. Pérez-Ayala A, Pérez-Molina JA, Norman F, Monge-Maillo B, Faro MV, López-Vélez R, , 2011. Gastro-intestinal Chagas disease in migrants to Spain: prevalence and methods for early diagnosis. Ann Trop Med Parasitol 105: 2529.[Crossref] [Google Scholar]
  15. De Oliveira RB, Troncon LE, Dantas RO, Menghelli UG, , 1998. Gastrointestinal manifestations of Chagas disease. Am J Gastroenterol 93: 884889.[Crossref] [Google Scholar]
  16. Meneghelli UG, , 1985. Chagas disease: a model of denervation in the study of digestive tract motility. Braz J Med Biol Res 18: 255264. [Google Scholar]
  17. Meneghelli UG, de Godoy RA, Macedo JF, de Oliveira RB, Troncon LE, Dantas RO, , 1982. Basal motility of dilated and non-dilated sigmoid colon and rectum in Chagas disease. Arq Gastroenterol 19: 127132. [Google Scholar]
  18. Cavenaghi S, Felicio OC, Ronchi LS, Cunrath GS, Melo MM, Netinho JG, , 2008. Prevalence of rectoanal inhibitory reflex in chagasic megacolon. Arq Gastroenterol 45: 128131.[Crossref] [Google Scholar]
  19. Netinho JG, Cunrath GS, Ronchi LS, , 2002. Rectosigmoidectomy with ileal loop interposition: a new surgical method for the treatment of chagasic megacolon. Dis Colon Rectum 45: 13871392.[Crossref] [Google Scholar]
  20. Iantorno G, Bassotti G, Kogan Z, Lumi CM, Cabanne AM, Fisogni S, Varrica LM, Bilder CR, Muñoz JP, Liserre B, Morelli A, Villanacci V, , 2007. The enteric nervous system in chagasic and idiopathic megacolon. Am J Surg Pathol 31: 460468.[Crossref] [Google Scholar]
  21. Da Silveira AB, D'Avila Reis D, de Oliveira EC, Neto SG, Luquetti AO, Poole D, Correa-Oliveira R, Furness JB, , 2007. Neurochemical coding of the enteric nervous system in chagasic patients with megacolon. Dig Dis Sci 52: 28772883.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 30 Aug 2014
  • Accepted : 08 Feb 2015
  • Published online : 06 May 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error