Abstract
We experienced a case of anorexia nervosa (AN) complicated by severe reflux esophagitis. The patient was an 18-Year-old female high school student, whose weight was 37 kg and height was 163 cm when she visited our hospital for the first time. Her chief complaints were amenorrhea and body weight loss. She had no episode of binge eating nor self-induced vomiting. She was admitted on the purposes of going through a full examination and improving nutrition. Her 0 days of hospitalization were over ten weeks, but her body weight did not increase, because she ate every meal but a small quantity. Ten months after the discharge, she underwent a gastro fiber scopic examination for epigastric pain. The findings indicated esophagitis ot grade B by LA classification. One year later, she underwent the same examination again due to epigastric pain and difficulty in swallowing, and severe reflux esophagitis of grade D was revealed. After administration of proton pump inhibitor for one month, the result of a gastro fiberscopy (GFS) was grade A. We considered that adding of the fragility of esophageal mucosa resulted from poor nourishment to the increase of transient lower esophageal sphincter relaxation caused by the delay of gastric emptying was the etiological cause in this case. It is known that bulimic patients are often complicated by esophagitis, and, consequently, we emphasize that, when patients complain pyrosis or epigastric pain, even in AN cases, gastro-esophageal reflux disease should be suspected and GFS should be carried out in early phases.
