Abstract
It is known that lower esophageal sphincter (LES) pressure in patients with idiopathic achalasia is higher than in normal subjects, but in patients with Chagas' disease, who have esophageal disease with similar clinical, manometric, and radiologic results, studies of LES pressure show contradictory findings. We measured the LES pressure in 118 patients with chronic Chagas' disease, 14 patients with idiopathic achalasia, and 50 control subjects using a perfused catheter and the stationary pull-through (SPT) technique. The patients with Chagas' disease had normal esophageal radiologic examination (group A, N=50), delay in esophageal clearance without dilatation (group B, N=41), or delay in esophageal clearance with dilatation (group C, N=27). The LES pressure of Chagas' disease patients of group A (18.6 ±9.1 mm Hg, mean ±SD), group B (17.8 ±9.7mm Hg), and group C (21.6 ±10.1 mm Hg) was lower (P<0.001) than the LES pressure of the controls (24.9 ±10.2 mm Hg). In patients with idiopathic achalasia, the LES pressure (40.7 ±17.8 mm Hg) was higher than in control subjects (P<0.01) and Chagas' disease patients (P<0.001). We conclude that the LES pressure of patients with Chagas' disease tended to be lower than that of control subjects and achalasia patients.
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References
Köberle F: Chagas' disease and Chagas' syndrome: The pathology of American trypanosomiasis. Adv Parasitol 6:63–116, 1968
Earlam RJ: Gastrointestinal aspects of Chagas' disease. Am J Dig Dis 17:559–571, 1972
Bettarello A, Pinotti HW: Oesophageal involvement in Chagas' disease. Clin Gastroenterol 5:103–117, 1976
Earlam R: Pathophysiology and clinical presentation of achalasia. Clin Gastroenterol 5:73–88, 1976
Dantas RO: Idiopathic achalasia and Chagasic megaesophagus. J Clin Gastroenterol 10:13–15, 1988
Dodds WJ, Dent J, Hogan WJ, Patel OK, Touli J, Arndorfer RC: Paradoxical lower esophageal sphincter contraction induced by cholecystokinin-octapeptide in patients with achalasia. Gastroenterology 80:327–333, 1981
Holloway RH, Dodds WJ, Helm JF, Hogan WJ, Dent J, Arndorfer RC: Integrity of cholinergic innervation to the lower esophageal sphincter in achalasia. Gastroenterology 90:924–929, 1986
Meneghelli UG: Chagas' disease: A model of denervation in the study of digestive tract motility. Braz J Med Biol Res 18:255–264, 1985
Dantas RO, Godoy RA, Oliveira RB, Meneghelli UG, Troncon LEA: Cholinergic innervation of the lower esophageal sphincter in Chagas' disease. Braz J Med Biol Res 20:527–532, 1987
Cohen S, Lipshutz W, Hughes W: Role of gastrin supersensitivity in the pathogenesis of lower esophageal sphincter hypertension in achalasia. J Clin Invest 50:1241–1247, 1971
Goyal RK, Rattan S: Neurohumoral, hormonal, and drug receptors for the lower esophageal sphincter. Gastroenterology 74:598–619, 1978
Dodds WJ, Hogan WJ, Miller WN, Barreras RF, Arndorfer RC, Stef JJ: Relationship between serum gastrin concentration and lower esophageal sphincter pressure. Am J Dig Dis 20:201–207, 1975
Dodds WJ, Dent J, Hogan WJ, Arndorfer RC: Effect of atropine on esophageal motor function in humans. Am J Physiol 240:G290-G296, 1981
Padovan W, Godoy RA, Dantas RO, Meneghelli UG, Oliveira RB, Troncon LEA: Lower oesophageal sphincter response to pentagastrin in chagasic patients with megaesophagus and megacolon. Gut 21:85–90, 1980
Heitman P, Espinoza J: Oesophageal manometric studies in patients with chronic Chagas' disease and megacolon. Gut 10:848–851, 1969
Csendes A, Strauszer T, Uribe P: Alterations in normal esophageal motility in patients with Chagas' disease. Am J Dig Dis 20:437–442, 1975
Paula-Costa MD, Rezende JM: Pressão basal do esfíncter inferior do esôfago no megaesôfago chagásico. Rev Assoc Med Brasil 24:269–272, 1978
Moraes-Filho JPP, Kohatsu OS, Bettarello A: Pressão basal do esfíncter inferior do esôfago na doença de Chagas: Megaesôfago e forma indeterminada. Rev Assoc Med Brasil 32:51–53, 1986
Dodds WJ, Hogan WJ, Stef JJ, Miller WN, Lyndon SB, Arndorfer RC: A rapid pull-through technique for measuring lower esophageal sphincter pressure. Gastroenterology 68:437–443, 1975
Hellemans J, Pelemans W, Vantrappen G: Pharyngoesophageal swallowing disorders and the pharyngoesophageal sphincter. Med Clin North Am 65:1149–1171, 1981
Dodds WJ, Kahrilas PJ, Dent J, Hogan WJ: Considerations about pharyngeal manometry. Dysphagia 1:209–214, 1987
Kahrilas PJ, Dent J, Dodds WJ, Hogan WJ, Arndorfer RC: A method for continuous monitoring of upper esophageal sphincter pressure. Dig Dis Sci 32:121–128, 1987
Mittal RK, Rochester DF, McCallum RW: Effect of the diaphragmatic contraction on lower oesophageal sphincter pressure in man. Gut 28:1564–1568, 1987
Welch RW, Drake ST: Normal lower esophageal sphincter pressure: A comparison of rapid vs slow pull-through techniques. Gastroenterology 78:1446–1451, 1980
Welch RW, Gray JE: Influence of respiration on recordings of lower esophageal sphincter pressure in humans. Gastroenterology 83:590–594, 1982
Boyle JT, Altschuler SM, Nixon TE, Tuchman DN, Pack AI, Cohen S: Role of the diaphragm in the genesis of lower esophageal sphincter pressure in the cat. Gastroenterology 83:590–594, 1982
Richter JE, Wu WC, Johns DN, Blackwell JN, Nelson JL, Castell JA, Castell DO: Esophageal manometry in 95 healthy adult volunteers: Variability of pressures with age and frequency of “abnormal” contractions. Dig Dis Sci 32:583–592, 1987
Kahrilas PJ, Dodds WJ, Hogan WJ, Kern M, Arndorfer RC, Reece A: Esophageal peristaltic dysfunction in peptic esophagitis. Gastroenterology 91:897–904, 1986
Dodds WJ: Instrumentation and methods for intraluminal esophageal manometry. Arch Intern Med 136:515–523, 1976
Kahrilas PJ, Kishk SM, Helm JF, Dodds WJ, Hang JM, Hogan WJ: Comparison of pseudoachalasia and achalasia. Am J Med 82:439–446, 1987
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Dantas, R.O., Godoy, R.A., Oliveira, R.B. et al. Lower esophageal sphincter pressure in Chagas' disease. Digest Dis Sci 35, 508–512 (1990). https://doi.org/10.1007/BF01536927
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DOI: https://doi.org/10.1007/BF01536927