1921
Volume 92, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

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.

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References

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