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Chagas gastrointestinal disease

Author
Rogelio Lopez-Velez, MD, DTMH, PhD
Section Editors
Peter F Weller, MD, MACP
Nicholas J Talley, MD, PhD
Deputy Editors
Elinor L Baron, MD, DTMH
Shilpa Grover, MD, MPH, AGAF

INTRODUCTION

Chagas disease is caused by infection with the protozoan parasite Trypanosoma cruzi; the major manifestations are Chagas cardiomyopathy and gastrointestinal disease [1].

Issues related to the epidemiology and prevention of Chagas disease, acute and chronic Chagas infection, and cardiac Chagas are discussed separately. (See "Chagas disease: Epidemiology and prevention" and "Chagas disease: Acute and congenital Trypanosoma cruzi infection" and "Chagas disease: Chronic Trypanosoma cruzi infection" and "Chagas heart disease: Clinical manifestations and diagnosis" and "Chagas heart disease: Treatment and prognosis".)

EPIDEMIOLOGY

Among individuals with the chronic indeterminate form of Chagas disease, approximately 20 to 30 percent progress over a period of one to three decades to clinically evident cardiac involvement, digestive involvement, or both [2]. Gastrointestinal manifestations are relatively rare in the setting of reactivation of chronic T. cruzi infection among organ transplant recipients or in patients with HIV infection, although there are reports of parasitic invasion of the peritoneum, intestine, stomach, esophagus, or larynx. (See "Chagas disease in the immunosuppressed host".)

The likelihood of digestive involvement may vary by region [3]. The digestive form is observed more frequently in the countries of the Southern Cone of South America and is rare in northern South America, Central America, and Mexico [4]. A high prevalence has been observed in the central region of Brazil. This geographic pattern is thought to be due to distribution of different T. cruzi genotypes [5].

The mortality associated with Chagas gastrointestinal disease is low, but symptoms can have a considerable impact on quality of life.

                      
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Literature review current through: Sep 2017. | This topic last updated: Sep 14, 2017.
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