Related Experiment Video
Updated: Jul 2, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
Vomiting and feeling fat--coincidence of achalasia and bulimia nervosa
Martin Teufel1, Georg Lamprecht, Stephan Zipfel
1Department of Internal Medicine VI-Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Tübingen, Germany. martin.teufel@med.uni-tuebingen.de
Objective:
In clinical practice it is often difficult to distinguish between organic and psychological vomiting.
Method:
We present a case of a 34-year-old woman with an 18-month history of vomiting with the initial diagnosis of bulimia nervosa (BN). However, the patient showed an unusual vomiting behavior. Therefore, further somatic diagnostic procedures were carried out leading to the additional diagnosis of achalasia. After successful interventional and surgical treatment for achalasia, further psychotherapeutic interventions were necessary because of worsening of the BN symptoms. A certain disturbed eating behavior seemed to persist at 3-year follow-up, while the medical condition had improved.
Conclusion:
It needs to be emphasized that careful diagnostic steps are indispensable to distinguish between psychological vomiting and organic vomiting. In case of two separate diseases a suitable treatment regime for each is required.
Related Concept Videos
Bulimia Nervosa
Pathophysiology of Vomiting
Esophageal Achalasia
Anorexia Nervosa
Symptoms and Physical Effects
Individuals with anorexia nervosa commonly exhibit extreme...
Pyloric Obstruction
Binge Eating Disorders

