Gastrointestinal Beriberi and Wernicke's Encephalopathy Presented as Chronic Dysphagia and Weight Loss
Bobbi Lee Roth, Yen‐Yi Peng
TL;DR
Chronic difficulty swallowing and weight loss can indicate gastrointestinal beriberi and Wernicke's encephalopathy.
Contribution
This case highlights the rare but important connection between chronic dysphagia and thiamine deficiency disorders.
Findings
Chronic dysphagia and weight loss may signal gastrointestinal beriberi.
Wernicke's encephalopathy can present with similar gastrointestinal symptoms.
Thiamine deficiency should be considered in patients with unexplained dysphagia and weight loss.
Abstract
Chronic dysphagia and weight loss can be presenting signs of gastrointestinal beriberi and Wernicke's encephalopathy.
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Taxonomy
TopicsAlcoholism and Thiamine Deficiency · Gastroesophageal reflux and treatments · Neurological and metabolic disorders
A 38‐year‐old male presents with a 3‐month history of intractable dysphagia, globus sensation, and an unintentional 80‐pound weight loss (Video 1). A swallowing study revealed oropharyngeal pooling. Initial workup, including neck CT, endoscopy, flexible laryngoscopy, and AChR antibodies, was unremarkable. He reported heavy alcohol use for two decades, consuming approximately two shots of hard liquor and 12 beers three times per week, which predated the onset of dysphagia. Two months after dysphagia began, he experienced generalized numbness. Unrecognized end‐gaze diplopia was noted during the initial interview. His chronic dysphagia significantly improved within days of starting 1000 mg oral thiamine, with full resolution in months. Paresthesia and diplopia also resolved promptly (Video 2) [1].
Author Contributions
Bobbi Lee Roth: validation, writing – review and editing. Yen‐Yi Peng: conceptualization, writing – original draft.
Consent
The authors confirm that written informed consent was obtained from the patient(s) for publication of this case report and accompanying videos/images. A copy of the written consent is available for review by the Editor‐in‐Chief of this journal on request.
Conflicts of Interest
The authors declare no conflicts of interest.
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