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Wilkie’s Syndrome Is Not Anorexia (And Misdiagnosis Can Be Fatal)

Wilkie’s syndrome, also known as superior mesenteric artery syndrome, is a disease often confused with anorexia due to the similarity of the symptoms. Most patients, especially women, often have weight loss, body image distortion, nausea, and vomiting.

Because of the similarity in symptoms, many patients end up being misdiagnosed with anorexia nervosa, when, in fact, they have a condition that does not merit psychopharmacological treatment or psychiatric care, but only surgery.

What Is Wilkie’s Syndrome?

This is a gastrointestinal disorder characterized by compression of the third portion of the duodenum (initial segment of the small intestine) due to anatomical deformation. It turns out that, in less than 0.013 percent of the population, the upper mesenteric artery creates a clamp in conjunction with the aorta, which ends up compressing the duodenum.

This alteration causes a kind of high intestinal obstruction that is the cause of the symptoms, so it ends up being a problem that needs surgical resolution and not psychiatric, and this is something that specialist doctors must take into account before making such a delicate diagnosis.

Symptoms of Superior Mesenteric Artery Syndrome

Although they are usually quite vague, we can list the most frequent symptoms:

  • Abrupt weight loss, with predominance of body fat

  • Abdominal distention after eating

  • Nausea

  • Vomiting

  • Epigastric pain

  • Intestinal obstruction (in severe cases)

How to Tell the Difference Between Anorexia and Wilkie’s Syndrome

Although there are symptoms in common between anorexia nervosa and Wilkie’s syndrome, we can name some determining differences between them.

However, it is important to point out that it is a doctor who should make the definitive diagnosis.

Patients with SMAS usually have a predominance of epigastric pain after eating, approximately half an hour or one hour later. In fact, this condition is aggravated if the person continues eating, something that does not occur with eating disorders. Furthermore, it seems that this pain is relieved by changes in posture, especially by placing themselves on the left side or in a prone position.

In addition, the psychiatric symptoms of anorexia do not appear in SMAS. One of the typical symptoms of anorexia is the distortion of the body image, where the person believes that they are overweight even though that’s not the case. While this occurs quite frequently in eating disorders, it is atypical of SMAS.

How Is Superior Mesenteric Artery Syndrome Diagnosed?

If we are talking about diagnostic studies, the best of all, also called “gold standard”, would be a barium study of the upper gastrointestinal tract, also called X-ray with barite contrast. This quick and simple study can save years of frustration and misdiagnosis.

How Is Wilkie’s Syndrome Treated?

Treatment of Wilkie’s syndrome often requires a combination of conservatory and surgical measures. From the conservative point of view, this could include an optimal diet, post-meal decompression measures, restitution of the hydro-electrolytic balance, and nasogastric decompression.

On the other hand, the most effective surgical techniques involve a surgery known as the “Strong procedure,” which seeks to readjust the conditions of the duodenum. Furthermore, it is possible to do other types of surgeries that are based on just sectioning that segment of the duodenum.

Wilkie’s syndrome is an easily diagnosed disease that only needs the expertise of a doctor who can spot it. However, the damage caused to people who are misdiagnosed with anorexia nervosa is incredible. Although the sufferer may have the same abrupt weight loss in conjunction with nausea and vomiting, the epigastric pain is totally different.

Moreover, psychiatric symptoms are much more prevalent in anorexia. A condition such as superior mesenteric artery syndrome can easily be diagnosed with a barium X-ray and treated with non-invasive or surgical measures, if necessary.

If these symptoms sound familiar to you, you may now be one step closer to understanding the true cause of your suffering. Keep fighting for your diagnosis, and don’t give up!

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