In developed countries, protozoal infections of the esophagus are extraordinarly rare and occur almost exclusively in patients with AIDS. In such patients, reported esophageal pathogens include Pneumocystis carinii, Cryptosporidium parvum, and Leishmania donovani. Therapy for these agents is generally ineffective except for trimethoprim-sulfamethoxazle combination therapy for Pneumocystis. Institution of HAART is the primary "therapy." In Central and South America where Trypanosoma cruzi is endemic, this organism characteristically involves the myenteric plexus of the esophagus resulting in an achalasia-like picture with megaesophagus termed Chaga's disease. This disorder mimics idiopathic achalasia clinically, radiographically, endoscopically, and manometrically. Treatment with niftutimox 8 to 10 mg/kg/d in 4 divided doses may be helpful if the disease is diagnosed early. However, patients who present with end-stage esophageal disease will gain little and should be treated similarly to idiopathic achalasia with surgery or endoscopic therapies.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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