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Esophageal Contractions in Chagas' Disease and in Idiopathic Achalasia

Dantas, Roberto Oliveira MD; Aprile, Lilian Rose Otoboni MD

Journal of Clinical Gastroenterology: November-December 2005 - Volume 39 - Issue 10 - p 863-868
doi: 10.1097/01.mcg.0000180633.07561.ce
Alimentary Tract: Clinical Research

Goals: The aim of this study was to compare the esophageal contractions in Chagas' disease and in idiopathic achalasia.

Background: It is suggested that the esophageal involvement caused by Chagas' disease and by idiopathic achalasia, although similar, shows some differences.

Study: We studied the contractions at 2, 7, 12, and 17 cm below the upper esophageal sphincter in 25 patients with idiopathic achalasia (15 with dilatation), 52 with Chagas' disease (22 with dilatation), and 18 controls. Each subject performed 5 swallows of a 5-mL bolus of water alternated with 5 dry swallows.

Results: In the distal esophageal body, the amplitude was lower in patients than in controls. Among patients with esophageal dilatation, the proximal amplitude was lower in patients with idiopathic achalasia, and the time interval between the contractions at 2 and 7 cm was longer in patients with Chagas' disease, the number of failed contractions was higher in Chagas' disease, and simultaneous contractions were more frequent in idiopathic achalasia. The simultaneous isobaric pressure in the distal esophagus was associated with an increase in proximal pressure that was higher than distal but lower than proximal swallowing pressure.

Conclusion: The results suggested that idiopathic achalasia and Chagas' disease cause similar impairment of distal esophageal motility, but in patients with esophageal dilatation the impairment of proximal motility may be not the same.

From Departamento de Clínica Médica, Faculdade de Medicina, Ribeirão Preto da Universidade de São Paulo, São Paulo, Brazil.

Received for publication December 14, 2004; accepted May 25, 2005.

Supported in part by Fundação de Apoio ao Ensino, Pesquisa e Assistência do Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, and Fundação de Estudos e Projetos, Pronex Grant No. 42/97.

Reprints: Roberto Oliveira Dantas, MD, Departamento de Clínica Médica, Faculdade de Medicina, Ribeirão Preto, Universidade de São Paulo 14049-900, Ribeirão Preto, São Paulo, Brazil (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.