Scurvy, a disease caused by vitamin C deficiency, may be making a comeback, with links to reflux medications like proton pump inhibitors and bariatric surgery.
While scurvy remains rare in developed countries, its symptoms, including bleeding gums, rashes and fatigue, can often be misdiagnosed as other conditions. If untreated, scurvy can lead to severe complications, including internal bleeding.
A study published in BMJ Case Reports, an online journal that shares cases on common and rare conditions from all specialties, highlighted the case of a man whose scurvy diagnosis took time to uncover.
The symptoms
A middle-aged man presented with painful red-brown spots on his legs, blood in his urine, and anaemia. Despite extensive testing ruling out autoimmune, inflammatory, and blood disorders, his symptoms continued to worsen.
Further investigation revealed that financial constraints had led to a poor diet lacking fruit and vegetables, as well as discontinued use of supplements prescribed after bariatric surgery.
Blood tests showed undetectable levels of vitamin C, alongside deficiencies in other nutrients. A diagnosis of scurvy was confirmed, and treatment with high-dose vitamin C and multivitamins led to a rapid improvement in his symptoms.
Reflux medication
Proton pump inhibitors (PPIs), commonly prescribed to manage gastroesophageal reflux disease (GERD), also emerged as risk factors in this case. These medications, while effective in reducing stomach acid, may interfere with the absorption of key nutrients, including vitamin C.
A patient’s long-term use of PPIs could compound nutritional deficiencies, particularly in the context of a limited diet and past bariatric surgery. This highlights the importance of monitoring nutritional health in individuals taking reflux medications over extended periods.
Additional risk factors for scurvy include:
- Smoking and alcohol use
- Eating disorders or restrictive diets
- Chronic conditions like kidney failure
- Low household income
How Peptest can help
For individuals managing reflux or recovering from bariatric surgery, tools like Peptest provide a simple, non-invasive way to monitor reflux by detecting pepsin in saliva – a key marker of reflux.
Measuring salivary pepsin levels with Peptest has the potential to reduce the time to diagnose reflux, minimise the use of PPI therapy, and streamline care for patients with reflux symptoms. By identifying and monitoring reflux early, Peptest can support personalised treatment strategies, helping to address both symptoms and underlying risks.
Peptest detects pepsin — the stomach enzyme that marks reflux — in a saliva sample. Collected at home, analysed in our UK laboratory, results back within 48 hours.
- Results in 48 hours
- No GP referral needed
- UK laboratory
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