Sílvia Roure1, Lluís Valerio2, Xavier Vallès2, Betty Morales3, M Immaculada Garcia-Diaz4, M Luisa Pedro-Botet5, Jordi Serra6. 1. North Metropolitan International Health Unit, Institut Català de la Salut, Universitat Autònoma de Barcelona, Santa Coloma de Gramenet, Spain; Infectious Diseases Unit, Internal Medicine Department, University Hospital Germans Trias i Pujol, Badalona, Spain. 2. North Metropolitan International Health Unit, Institut Català de la Salut, Universitat Autònoma de Barcelona, Santa Coloma de Gramenet, Spain. 3. Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Badalona, Spain. 4. Radiology Unit, SAP Santa Coloma de Gramenet, Santa Coloma de Gramenet, Spain. 5. Infectious Diseases Unit, Internal Medicine Department, University Hospital Germans Trias i Pujol, Badalona, Spain. 6. Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Badalona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
Abstract
BACKGROUND: Immigration-related new diseases pose a growing challenge for healthcare services in receptor countries. Following Latin American migration, Chagas disease has inevitably appeared in Europe. AIM: To determine the prevalence and characteristics of oesophageal motility disorders in immigrants infected with Trypanosoma cruzi, using high resolution oesophageal manometry (HREM). METHODS: In all newly-diagnosed cases with chronic Chagas infection referring upper digestive symptoms, a protocolized clinical evaluation and complementary tests including barium oesophagogram and HREM were carried out. As control group, 14 healthy subjects from the same endemic areas were studied with HREM. RESULTS: We included 61 patients (46 female, 15 male; age range 26-63 years). Only seven patients (11%) had a minor alteration on barium oesophagogram. By contrast, 23 (37%) patients showed an alteration in oesophageal manometry, mainly minor motility disorders (34%). Only one healthy control (7%) had a minor motility disorder at HREM (p = 0.029 vs. patients). CONCLUSIONS: Oesophageal motor disorders in infected immigrants with Chagas disease are common, and mainly characterized by a minor motility disorder that is not detected by barium oesophagogram. Hence, as well as barium oesophagogram examination, HREM should be considered, to assess oesophageal damage in this specific group of patients.
BACKGROUND: Immigration-related new diseases pose a growing challenge for healthcare services in receptor countries. Following Latin American migration, Chagas disease has inevitably appeared in Europe. AIM: To determine the prevalence and characteristics of oesophageal motility disorders in immigrants infected with Trypanosoma cruzi, using high resolution oesophageal manometry (HREM). METHODS: In all newly-diagnosed cases with chronic Chagas infection referring upper digestive symptoms, a protocolized clinical evaluation and complementary tests including barium oesophagogram and HREM were carried out. As control group, 14 healthy subjects from the same endemic areas were studied with HREM. RESULTS: We included 61 patients (46 female, 15 male; age range 26-63 years). Only seven patients (11%) had a minor alteration on barium oesophagogram. By contrast, 23 (37%) patients showed an alteration in oesophageal manometry, mainly minor motility disorders (34%). Only one healthy control (7%) had a minor motility disorder at HREM (p = 0.029 vs. patients). CONCLUSIONS: Oesophageal motor disorders in infected immigrants with Chagas disease are common, and mainly characterized by a minor motility disorder that is not detected by barium oesophagogram. Hence, as well as barium oesophagogram examination, HREM should be considered, to assess oesophageal damage in this specific group of patients.
Entities:
Keywords:
American trypanosomiasis; Chagas disease; Trypanosoma cruzi; dysphagia; high resolution manometry; oesophageal motility disorders
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