In the chronic digestive form of the disease, the clinical  manifestations result from dysperistalsis of the esophagus and colon  caused by destruction of the myenteric plexuses, which consequently  leads to megaesophagus and megacolon. Although isolated cases of  autonomic disorders of the esophagus have been described in the acute  phase of the disease, these occur mostly in the chronic phase, when the  dysperistalsis and spasms are accompanied by enlargement of the  esophagus. This picture shows the evolution of megaesophagus. Esophagus dysperistalsis grade I (a), and megaesophagus grade II (b), grade III (c) and grade IV (d)  

In the chronic digestive form of the disease, the clinical manifestations result from dysperistalsis of the esophagus and colon caused by destruction of the myenteric plexuses, which consequently leads to megaesophagus and megacolon. Although isolated cases of autonomic disorders of the esophagus have been described in the acute phase of the disease, these occur mostly in the chronic phase, when the dysperistalsis and spasms are accompanied by enlargement of the esophagus. This picture shows the evolution of megaesophagus. 

Esophagus dysperistalsis grade I (a), and megaesophagus grade II (b), grade III (c) and grade IV (d)  

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