Mild thiamine deficiency may be associated with gastrointestinal symptoms without obvious neurologic findings.
Patient selection: marginal diet and/or chronic alcoholism
Clinical features of gastrointestinal beriberi:
(1) anorexia
(2) nausea
(3) vomiting
(4) abdominal pain
These symptoms may be present for months or years if the thiamine deficiency is marginal.
The diagnosis is supported if parenteral thiamine reverses the symptoms (vomiting makes oral replacement difficult).
The diagnosis may be challenging since the symptoms can be seen with other gastrointestinal disorders.
