Medical Mystery: Sandwich-Induced Fainting

Dec. 19, 2008— -- When British physician Dr. Russell Cherry saw a 26-year-old woman at his office in January, he expected the visit to be a routine consultation. But that was before he found out that sandwiches were making her pass out.

The woman complained that she had been experiencing intermittent and unexplained blackouts for the last 10 years. The episodes had sent her to the hospital twice.

An extensive battery of medical tests had revealed nothing out of the ordinary. But Cherry said the fact that her fainting spells appeared to be associated with certain foods offered a tantalizing clue to her condition.

"She made it very clear to me that when she had food she felt funny almost every time, and she had been feeling this way for many years," he said. "I could tell that it was something organic; it sounded real. I could tell that it was not something that she was making up."

Cherry, with the assistance of Dr. Christopher Boos, a cardiologist at University Hospital Birmingham in the United Kingdom, learned that the woman had a rare condition known as swallow syncope, in which her heart would temporarily stop because of a nerve reaction triggered by the swallowing.

Sandwiches and carbonated beverages were the primary culprits in her unusual condition. While for most people the biggest threat posed by these foods would be the possibility of heartburn, for this patient the stakes were much higher.

The last time she passed out, she was eating a sandwich while driving. Moreover, her condition also caused her to avoid eating in general. With the woman standing at nearly 5 feet, 4 inches and weighing little more than 102 pounds, doctors initially suspected that she suffered from an eating disorder, although subsequent tests revealed that this was not the case.

"The patient was becoming increasingly frustrated and was desperate to get to the bottom of these potentially disabling symptoms," Boos said.