Patient discussions
Patients with cardiac manifestations require: obesity correction and maintenance at optimal weight; control of salt consumption; water intake restriction (for the most severe cases); elimination of complicating factors; prevention of alcohol use; individualized physical activity programs (in accordance with the cardiopathy grade and the patient age); and influenza and pneumococcal vaccination (in cases of advanced cardiopathy).
Patients with esophageal manifestations should be advised to: chew food well; consume liquid and semi-solid food if necessary; avoid food consumption before sleep; and avoid taking tablets at night.
Patients with colonic manifestations require: habitual diet; restriction of constipating foods (e.g., banana, guava, jaboticaba); abundant ingestion of water (at least 2 L/day if there is no heart failure); increased consumption of food that favors intestinal transit (e.g., pawpaw, plum, orange, high-fiber food, other foods known to the patient that favor reflex evacuation); systematic attention to the wish to evacuate; osmotic laxatives or mineral oil (avoid administration at night due to risk of aspiration); enemas twice a week; and avoidance of constipating medications (e.g., opioids, diuretics, antidepressants, antihistamines, anticonvulsants, antacids with aluminum hydroxide) if possible.
Patients should be advised to report the following symptoms to their physicians: cutaneous erythema with pruritus; pain and paresthesia in the plantar and palmar regions; dysgeusia; anemia; or gastrointestinal symptoms.
Patients with indeterminate Chagas disease may carry on their normal lives, and there is no need to exclude them from work or other daily activities. This recommendation is very important to avoid stigmatization.[72] A positive serologic result for Trypanosoma cruzi antibodies does not require termination of employment in most professions; however, many experts recognize it could be an issue for pilots or drivers who are responsible for transporting many people, or for people who operate heavy machinery or equipment, due to the risk of cardiac arrhythmias or sudden cardiac arrest. Generally, working does not worsen the patient’s condition, regardless of the clinical form. Rarely, people with acute infection may temporarily be unable to work due to treatment.[13]
Patients should be counseled not to donate blood.
Patient fact-sheets are available from the Centers for Disease Control and Prevention and the World Health Organization:
CDC: Parasites - American trypanosomiasis (also known as Chagas disease) Opens in new window
WHO: Chagas disease (American trypanosomiasis) Opens in new window
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