Thiamine deficiency is significant across gastroenterology and sepsis, not just alcohol care

Abstract

Wernicke-Korsakoff syndrome and Wernicke's encephalopathy are both progressive illnesses that result from thiamine deficiency. To assess and screen for thiamine levels, clinical staff have traditionally relied on the triad of ophthalmoplegia, cerebellar dysfunction and either an altered mental state or mild memory impairment. However, these symptoms are late signs of illness, and treatment efficacy may be limited due to permanent thalamus damage. This is costly in terms of both healthcare resources and the patient's health. The signs of thiamine deficiency are similar to those of early sepsis, and they can only be identified after prolonged assessment and testing. Patients who have significant illness that results in gastrointestinal imbalance or periods of malnutrition, malabsorption or protracted vomiting may present to hospital many days after the symptoms have commenced. This can result in patients missing life-improving treatment due to diagnostic overshadowing or treatment only being offered to those identified as having a history of alcohol misuse.