Understanding Beriberi: Causes, Symptoms, and Treatment

Introduction to Beriberi

Beriberi is a disease that results from a severe deficiency of thiamine, also known as vitamin B1. The term 'beriberi' is derived from the Sinhalese word meaning 'aching joints' or 'painful gout'. This disease primarily affects the nervous system but can also impact the cardiovascular and gastrointestinal systems.

Causes of Beriberi

The main cause of beriberi is the insufficient intake of thiamine, a necessary vitamin for metabolism and energy production. This deficiency can occur in several scenarios:

Poor Diet: Consuming diets primarily consisting of polished white rice can lead to beriberi due to the removal of the thiamine-rich husk. Chronic Alcoholism: Alcohol consumption interferes with thiamine absorption and utilization, leading to deficiency. Gastric Bypass Surgery: This surgical procedure can cause nutritional deficiencies, including thiamine. Maternal Thiamine Deficiency: If a mother has thiamine deficiency, her infant can also develop beriberi.

Symptoms of Beriberi

Beriberi can present with a wide range of symptoms, depending on the severity and duration of the thiamine deficiency. These can be grouped into neurological, cardiovascular, and gastrointestinal symptoms:

Neurological Symptoms

Decreased memory and irritability Sleep disturbances Wernicke encephalopathy (a condition involving damage to the brain) Lower extremity paresthesias (numbness and tingling) Acute pain in the limbs Muscle cramps Decreased vibratory sensation Absent knee and ankle jerks Muscle atrophy Foot drop (inability to lift the front part of the foot)

Cardiovascular Symptoms

Tachycardia (rapid heart rate) Chest pain Wide pulse pressure Heart failure with orthopnea (difficulty breathing when lying down) and edema (swelling) Hypotension (low blood pressure) and shock

Gastrointestinal Symptoms

Anorexia (loss of appetite) Abdominal discomfort Constipation Dysphagia (difficulty swallowing)

Types of Beriberi

There are two primary types of beriberi, namely wet and dry beriberi:

Wet Beriberi: This form mainly affects the heart, causing heart failure. It is characterized by weakened capillary walls and edema. Dry Beriberi: This form causes wasting and partial paralysis due to damaged peripheral nerves.

Diagnosing Beriberi

Differential diagnosis includes symptoms associated with thiamine deficiency. A thorough physical examination, along with diagnostic tests such as blood tests to measure thiamine levels, can help identify beriberi.

Treatment of Beriberi

The primary treatment for beriberi is the administration of thiamine, either through injection or oral tablets. Quick and dramatic recovery can be achieved within hours, improving the patient's health condition.

Thiamine-rich foods include:

Pork Peas Wheat bran Cereals and oatmeal Liver Green leafy vegetables Fresh fruits and dairy products High-protein diet with adequate caloric intake B-complex vitamins

For individuals with thiamine deficiency due to alcoholism, thiamine supplements and thiamine hydrochloride might be necessary as part of a B-complex concentrate regimen.