Chagas gastrointestinal disease
- Rogelio Lopez-Velez, MD, DTMH, PhD
Rogelio Lopez-Velez, MD, DTMH, PhD
- Associate Professor
- Alcala University
- National Referral Unit for Tropical Diseases, Infectious Diseases Department
- Ramón y Cajal University Hospital, Madrid, Spain
- Section Editors
- Peter F Weller, MD, MACP
Peter F Weller, MD, MACP
- Editor-in-Chief — Infectious Diseases
- Section Editor — Tropical Medicine
- William Bosworth Castle Professor of Medicine
- Harvard Medical School
- Professor of Immunology and Infectious Diseases
- Harvard T. H. Chan School of Public Health
- Nicholas J Talley, MD, PhD
Nicholas J Talley, MD, PhD
- Section Editor — Motility Disorders
- Professor of Medicine, University of Newcastle, Australia
- Adjunct Professor of Medicine and Epidemiology and Consultant, Mayo Clinic, Rochester, MN
- Adjunct Professor, University of North Carolina
- Deputy Editors
- Elinor L Baron, MD, DTMH
Elinor L Baron, MD, DTMH
- Deputy Editor — Infectious Diseases
- Assistant Clinical Professor of Medicine
- Tufts University School of Medicine
- Shilpa Grover, MD, MPH, AGAF
Shilpa Grover, MD, MPH, AGAF
- Deputy Editor — Gastroenterology/Hepatology
- Assistant Professor of Medicine, Part-time
- Harvard Medical School
Chagas disease is caused by infection with the protozoan parasite Trypanosoma cruzi; the major manifestations are Chagas cardiomyopathy and gastrointestinal disease .
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".)
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 . 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 . 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 . 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 .
The mortality associated with Chagas gastrointestinal disease is low, but symptoms can have a considerable impact on quality of life.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CLINICAL MANIFESTATIONS
- Disease onset and progression
- Esophageal manifestations
- Colonic manifestations
- Other manifestations
- EVALUATION FOR GASTROINTESTINAL INVOLVEMENT
- Our approach
- Patients with suspected esophageal involvement
- - Barium esophagram
- - Esophageal manometry
- - Upper gastrointestinal endoscopy
- Patients with suspected colonic involvement
- - Contrast radiography
- - Colonoscopy
- - Anorectal manometry
- DIFFERENTIAL DIAGNOSIS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS