Case Report

Achalasia as a complication of bulimia nervosa: A case report

Meryem O. Kutuk, Gulen Guler, Ali E. Tufan, Fevziye Toros, Umut Kaytanli
South African Journal of Psychiatry | Vol 23 | a996 | DOI: https://doi.org/10.4102/sajpsychiatry.v23i0.996 | © 2017 Meryem O. Kutuk, Gulen Guler, Ali E. Tufan, Fevziye Toros, Umut Kaytanli | This work is licensed under CC Attribution 4.0
Submitted: 24 April 2016 | Published: 07 February 2017

About the author(s)

Meryem O. Kutuk, Department of Child and Adolescent Psychiatry, Baskent University, Turkey
Gulen Guler, Department of Child and Adolescent Psychiatry, Elazig Mental Health Hospital, Turkey
Ali E. Tufan, Department of Child and Adolescent Psychiatry, Abant İzzet Baysal University, Turkey
Fevziye Toros, Department of Child and Adolescent Psychiatry, Mersin University, Turkey
Umut Kaytanli, Department of Child and Adolescent Psychiatry, Zeynep Kamil Women and Children’s Diseases Education and Research Hospital, Turkey


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Abstract

Objective: Oesophageal achalasia is a medical condition characterised by oesophageal aperistalsis, an increased resting pressure with partial or incomplete relaxation of the lower oesophageal sphincter. Bulimia nervosa (BN) is an eating disorder manifested by binge eating attacks followed by recurrent inappropriate compensatory behaviours, such as self-induced vomiting and excessive exercise. Dysphagia, regurgitation, vomiting, retrosternal pain, heartburn, weight loss, avoidance of eating, consumption of large amount of liquids and aberrant eating behaviours are symptoms of both achalasia and BN. Owing to these common signs and symptoms, oesophageal achalasia can be misdiagnosed as an eating disorder. In addition, oesophageal achalasia can occur as a complication of BN. It is often difficult to distinguish organic and psychological vomiting or comorbidity because of overlapping of the symptoms.

Case report: We report the case of a patient who developed oesophageal achalasia following severe, repetitive vomiting as a complication of BN.

Conclusion: We want to raise awareness regarding the development of a medical illness in the presence of a psychiatric disorder. Importantly, physicians should have a fundamental knowledge of these two diseases regarding their clinical patterns to differentially diagnose one or both disorders as quickly as possible.


Keywords

Esophageal achalasia; Bulimia nervosa; Child psychiatry

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Crossref Citations

1. Eating disorder or oesophageal achalasia during adolescence: diagnostic difficulties
Aurélie Letranchant, Bénédicte Pigneur, Martine Flament, Nathalie Godart
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity  year: 2018  
doi: 10.1007/s40519-018-0513-2