A case of vomiting in an anorexic achalasic patient

E. Scarpellini, S. Cafarotti, A. Cesario, F. Lococo, S. Margaritora, M. Gabrielli, A. Tortora, A. Gasbarrini, P. Granone

Internal Medicine Department, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. agasbarrini@rm.unicatt.it
and Division of General Thoracic Surgery, School of Medicine, IRCSS San Raffaele Pisana, Rome, Italy

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• Gastroenterology

Wernicke’s encephalopathy is a neurological disorder caused by thiamine (vitamin B1) deficiency characterized by vertigo, ataxia, and mental confusion. Wernicke’s encephalopathy has a causative association with alcoholism but recently there has been an increased prevalence also in other clinical conditions. In literature potentially fatal Wernicke’s encephalopathy onset in an advanced achalasia has been previously reported only once.

We describe for the first time an improvement of achalasic symptoms in a young patient affected by end-stage achalasia and anorexia nervosa (coming from ineffective Heller-Dor myotomy) after vitamin B1 supplementation. This case report suggest a potential positive impact of B1 supplementation on end-stage achalasic patients and requires systematic studies to confirm this observation.

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