Achalasia may mimic anorexia nervosa, compulsive eating disorder, and obesity problems.

TL;DR: The case of a young man referred for evaluation of anorexia nervosa, who, after investigation, turned out to be suffering from achalasia, is reported.

About: This article is published in Psychosomatics.The article was published on 2006-05-01 and is currently open access. It has received 11 citations till now. The article focuses on the topics: Anorexia nervosa (differential diagnoses).

Summary

Achalasia May Mimic Anorexia Nervosa, Compulsive Eating Disorder, and Obesity Problems

• In the past, physicians did exhaustive medical evaluation in the pursuit of organic pathology for patients with eating disorders.
• 1 Judging from the literature, the incidence of anorexia nervosa increased over the past century until the 1970s, 2 and now, physicians have an increased awareness of it and find it easier to diagnose.
• The consequence is the increasing failure to notice organic pathology in patients who have a history of eating disorders.
• The authors report the case of a young man referred for evaluation of anorexia nervosa, who, after investigation, turned out to be suffering from achalasia.

Case Report

• Mr. A, a 24-year-old Caucasian patient, had a history of vomiting and a 60-kg weight loss over the preceding 7 months (Body Mass Index [BMI] at admission: 17.6).
• Frequently, the parents would force him to eat and wait with him during some time after meals to make sure that he did not vomit, because the boy had uncontrollable vomiting after every meal.
• The patient stated that he often had chest pain after food or liquid intake.
• Body-image distortions were absent, but the intention to lose weight was present at the early stage.
• She was currently receiving psychotherapy for depression.

Discussion

• Dysphagia is the initial and main clinical feature of achalasia.
• 4 During this period, achalasia can be mistaken for anorexia nervosa.
• Patients with eating disorders frequently have gastric emptying abnormalities causing bloating, postprandial fullness, and vomiting.
• These symptoms usually improve with refeeding, but sometimes promotility agents may be necessary.
• They differentiate between two groups of symptoms: first, dysphagia, odynophagia, heartburn, and reflux have esophageal origins and occur in achalasia.

Postconcussional Symptoms Not a Syndrome

• Taber's Cyclopedic Medical Dictionary defines syndrome as "a group of symptoms, signs, laboratory findings, and physiological disturbances that are linked by a common anatomical, biochemical, or pathological history.", also known as TO THE EDITOR.
• It is my view that symptoms typically attributed to post-concussion are so nonspecific and are associated with such a wide variety of other conditions that they do not meet the definition of a syndrome.
• The injury claimants had no history of brain injury or toxic exposure.
• 5 McAllister and Arciniegas 6 pointed out that the term "post-concussive syndrome" is used inconsistently in the literature, that the symptoms have high base rates in the general population, and that they are nonspecific in nature.
• It is unfortunate that Dr. Hall and colleagues have not referenced these controversies in their otherwise excellent review article.

Frequently asked questions

Q1. What contributions have the authors mentioned in the paper "Achalasia may mimic anorexia nervosa, compulsive eating disorder, and obesity problems" ?

The authors report the case of a young man referred for evaluation of anorexia nervosa, who, after investigation, turned out to be suffering from achalasia.