Total and segmental colonic transit time in constipated patients with ChagasÆ disease without megaesophagus or megacolon

ABSTRACT

Manometric and pharmacological tests have shown that motor abnormalities may occur in the non-dilated colons of chagasic patients. In order to investigate the presence of abnormalities of colonic function in constipated patients with Chagas disease (ChC) without megaesophagus or megacolon, studies of total and segmental colonic transit time with radiopaque markers were performed on 15 ChC patients, 27 healthy volunteers and 17 patients with idiopathic constipation (IC). The values obtained for the control group were similar to those reported in the literature (total colonic time 34.1 + or - 15.6 h; right colon 9.9 + or - 7.3 h; left colon 10.8 + or - 10 h, and rectosigmoid 12.6 + or - 9.9 h). Colonic transit time data permitted us to divide both IC and ChC patients into groups with normal transit and those with slow colonic transit. Colonic inertia was detected in 41 percent of IC patients and in 13 percent of ChC patients; left colon isolated stasis (hindgut dysfunction) was detected in 12 percent of IC patients and 7 percent of ChC patients, and outlet obstruction was detected in 6 percent of IC patients and 7 percent of ChC patients. There were no significant differences in total or segmental colonic transit times between slow transit IC and slow transit ChC patients. In conclusion, an impairment of colonic motility was detected in about 30 percent of constipated patients with Chagas disease without megaesophagus or megacolon. This subgroup of patients presented no distinctive clinical feature or pattern of colonic dysmotility when compared to patients with slow transit idiopathic constipation