Help for bleeding caused by bulimia

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Bulimia nervosa (BN) is a serious eating disorder that can have numerous medical complications if left untreated. Perhaps one of the most alarming of these for the person suffering from the eating disorder is the appearance of blood after self-induced vomiting.

If this has happened to you, you’re probably concerned about where the blood is coming from and if this is something that can be treated, quickly and effectively.

This article will go through what causes blood to appear in vomit, how the problem can be treated, and where you or your loved one can get help with disordered eating behaviors.

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What causes bulimia blood in vomit?

One of the most recognizable characteristics of bulimia nervosa is the purging behavior of self-induced vomiting, which usually occurs after an episode of binge eating. Repeated and recurring episodes of forced vomiting can be extremely harsh on the body, particularly the esophagus and the throat.

The esophagus is the tube of muscle that connects the mouth to the stomach. The blood vessels in the esophagus are thinner than those in other parts of the body, so they are more prone to rupturing through excessive pressure.

Regularly, forcing large amounts of food back up the esophagus increases the pressure on the blood vessels, causing them to swell and rupture, resulting in bleeding. This is what leads to the appearance of blood in vomit and it is known as esophageal varices, or swollen veins. (1)

The signs and symptoms of esophageal varices are not just limited to hematemesis (blood in vomit). They also include:

  • Bloody stools
  • Black stools
  • Abdominal pain
  • Lightheadedness
  • Fainting or shock due to blood loss

Repeated episodes of forceful vomiting can also cause tears in the lining of your esophagus, known as Mallory-Weiss syndrome This too results in bleeding, which can be severe and life-threatening. (2)

The symptoms of Mallory-Weiss syndrome are similar to those of esophageal varices, with the addition of diarrhea, and vomit that is bright red or looks like coffee grounds. (3)

When to seek medical treatment for bleeding?

If you or someone you know has experienced blood in their vomit after a purging episode, it’s important to seek immediate medical treatment. 

Esophageal varices or Mallory-Weiss syndrome should never be taken lightly. Even just a small amount of blood in your vomit could be an indicator of a more serious bleed within the esophagus or other part of the gastrointestinal system, which will need to be controlled as soon as possible to prevent further complications. 

In these rare cases of severe internal bleeding, you may experience a drop in blood pressure, a rapid pulse, difficulty producing urine, and even shock. (2)

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Treating damage to the esophagus and throat caused by bulimia 

Once you’ve had one episode of bleeding while purging, your risk of more bleeding greatly increases. (4) If you have bulimia nervosa, and don’t give your body enough time to heal or treat the esophageal varices effectively, you’re likely to experience recurrent bleeding. (1)

To address acute damage to the esophagus and bleeding, doctors will typically use a combination of medications and treatments, including: (4)

  • Beta-blockers, a type of medication that reduces blood pressure
  • Endoscopic band ligation, which is a procedure that uses elastic bands to restrict bleeding veins
  • Medications to slow the blood flow to the veins of the esophagus
  • Applying pressure to the bleeding veins, for example with an inflated balloon in the esophagus, known as a balloon tamponade
  • Blood transfusions and administration of clotting factors to restore blood volume and stop the bleeding.

The best way to treat and prevent esophageal varices and Mallory-Wiess syndrome, is to address the underlying cause, which in this case is bulimia nervosa

Early treatment and intervention in cases of bulimia nervosa can prevent further damage resulting from esophageal bleeding and other complications of the eating disorder. Additionally, professional help from a multidisciplinary team will help a person to heal emotionally, physically, psychologically, and medically.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Resources

  1. Ekern, B., Ekern, B., About Baxter Ekern Baxter is the Vice President of Ekern Enterprises, & View all posts by Baxter Ekern →. (2015, June 15). Esophageal varices and bulimia. Eating Disorder Hope. Retrieved April 29, 2022, from https://www.eatingdisorderhope.com/blog/esophageal-varices-and-bulimia 
  2. WebMD. (n.d.). Bulimia: Physical risks, what happens, exams and tests. WebMD. Retrieved April 29, 2022, from https://www.webmd.com/mental-health/eating-disorders/bulimia-nervosa/bulimia-effects-body 
  3. Mallory-Weiss tear. Johns Hopkins Medicine. (2019, November 19). Retrieved April 29, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/malloryweiss-tear 
  4. Mayo Foundation for Medical Education and Research. (2021, February 20). Esophageal varices. Mayo Clinic. Retrieved April 29, 2022, from https://www.mayoclinic.org/diseases-conditions/esophageal-varices/symptoms-causes/syc-20351538 
  5. WebMD. (n.d.). Bulimia nervosa treatment - medications, therapies, self-care, and specialists. WebMD. Retrieved April 29, 2022, from https://www.webmd.com/mental-health/eating-disorders/bulimia-nervosa/understanding-bulimia-treatment

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