{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T22:24:48Z","timestamp":1772490288938,"version":"3.50.1"},"reference-count":23,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,6,15]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>Nausea and vomiting during pregnancy are very common; however, when persistent symptoms lead to severe malnutrition, other conditions should be considered. We present a patient with severe postprandial nausea and vomiting resulting in 120 lb weight loss. She was treated for presumed hyperemesis gravidarum but diagnosed with achalasia type 1 upon further work-up. The pregnancy was further complicated by fetal growth restriction, shortened cervix and preterm premature rupture of membranes, and resulted in delivery at 26 weeks of gestation. Postpartum, she underwent a peroral endoscopic <jats:italic>myotomy<\/jats:italic> procedure and has returned to normal body mass index.<\/jats:p>\n               <jats:p>The differential for nausea\/vomiting is broad, and major medical conditions can manifest for the first time during pregnancy. Severe malnutrition adversely affects maternal and fetal health. Further work-up should be pursued when symptoms cannot otherwise be explained.<\/jats:p>","DOI":"10.1136\/bcr-2023-258792","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T22:45:22Z","timestamp":1719269122000},"page":"e258792","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Primary achalasia diagnosed during pregnancy: rare cause of nausea and vomiting"],"prefix":"10.1136","volume":"17","author":[{"given":"Jenny Y","family":"Mei","sequence":"first","affiliation":[{"name":"Maternal-Fetal Medicine, Obstetrics and Gynecology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorian","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Gastroenterology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine, Obstetrics and Gynecology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashmi","family":"Rao","sequence":"additional","affiliation":[{"name":"Maternal-Fetal Medicine, Obstetrics and Gynecology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"2025082712145221000_17.6.e258792.1","article-title":"Interventions for nausea and vomiting in early pregnancy","volume":"2015","author":"Matthews","year":"2015","journal-title":"Cochrane Database Syst 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