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February 10, 2012

Chagas Disease (American Trypanosomiasis)

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What is Chagas disease?

Chagas disease (also termed American trypanosomiasis) is an infection caused by a protozoan parasite (Trypanosoma cruzi) that can result in acute inflammatory skin changes (chagomas) and eventually may cause infection and inflammation of many other body tissues, especially those of the heart and intestinal tract. The disease may have three phases in an individual: acute, with mild or no symptoms that may last weeks to about two months; intermediate or indeterminate phase that has few if any symptoms and may last 10-20 years or longer; and chronic, with the more severe symptoms appearing from gradual chronic organ damage (especially heart and intestinal although other organs may be affected) with symptoms that usually remain for life. People with Chagas disease seen in the U.S. usually have acquired it while living in a country where the disease is endemic (Mexico, Central and South America). The CDC estimates about 8-11 million people are infected in countries where the disease is endemic.

American trypanosomiasis (Chagas disease) is distinguished from African trypanosomiasis (sleeping sickness) by the part of the world where they occur, their vectors, their different symptoms and different treatments (see Table 1).

Table 1

Comparison of American (Chagas disease) and African trypanosomiasis (sleeping sickness)

  American trypanosomiasis African trypanosomiasis
Cause T. cruzi T. brucei (subspecies)
Main vector Triatominae bugs (kissing bugs) Tsetse fly
Main symptoms Chagomas, heart, gastrointestinal Chancres, nighttime insomnia, seizures
Treatment Benznidazole, nifurtimox; symptomatic treatments in chronic phase Suramin, melarsoprol, pentamidine, eflornithine




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Chagas Disease

Constipation facts

  • Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week.
  • Constipation usually is caused by the slow movement of stool through the colon.
  • There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
  • The two disorders limited to the colon that cause constipation are colonic inertia and pelvic floor dysfunction.
  • Medical evaluation for the cause of constipation should be done when constipation is of sudden onset, severe, worsening, associated with other worrisome symptoms such as loss of weight, or is not responding to simple, safe treatments.
  • Medical evaluation of constipation may include a history, physical examinatio...

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