Hipocontratilidade do esófago em pacientes com doença de Chagas e pacientes com acalasia idiopática

Arquivos de Gastroenterologia 01/2000; 37(1). DOI: 10.1590/S0004-28032000000100008
Source: DOAJ


Em pacientes com esofagopatia chagásica e pacientes com acalásia, a amplitude das contrações esofágicas está diminuída. Como nem todas as deglutições são seguidas de contrações com baixa amplitude, avaliamos o número de contrações com amplitude abaixo de 30 mm Hg em 40 voluntários assintomáticos, 99 pacientes com doença de Chagas e 14 pacientes com acalásia idiopática. Cada paciente ou voluntário realizou 10 deglutições de 5 mL de água e o registro das contrações foi feito a 5 cm, 10 cm e 15 cm proximal ao esfíncter inferior do esôfago. Neste registro foi utilizado o método manométrico com perfusão contínua. O número de contrações com hipocontratilidade foi maior nos pacientes com doença de Chagas e pacientes com acalásia do que nos voluntários (P <0,05). Pacientes chagásicos com trânsito lento no exame radiológico mas sem dilatação do esôfago tiveram mais contrações com baixa amplitude do que pacientes com exame radiológico normal (P <0,01). O mesmo resultado se obteve quando da análise do número de indivíduos com três ou mais contrações com baixa amplitude (P <0,01). Os pacientes chagásicos com disfagia tiveram mais contrações com hipocontratilidade do que aqueles sem disfagia (P <0,05). Concluímos que na doença de Chagas e na acalásia idiopática ocorre maior número de contrações esofágicas com baixa amplitude do que em pessoas normais, o que deve contribuir para a sintomatologia dos pacientes.

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