Why does bulimia damage the GI tract?
Eating disorders of all types can have a number of physical symptoms, but bulimia nervosa is particularly tied to GI and upper respiratory tract issues. That's mostly due to the frequent use of self-induced vomiting as purging behavior.
When someone vomits, it introduces their stomach contents—including stomach acid—to the mucosal lining or the tissue that lines the throat. Repeated exposure to caustic stomach acid can eventually damage that lining, leading to issues like acid reflux and other sensitivities.1
The act of vomiting also puts stress on the esophageal muscles, forcing them to work in reverse. And while the body can handle this type of action, it's not meant to do so on a regular basis. This can weaken the muscles involved, which can cause further issues with swallowing and keeping food down.1
Initiating self-induced vomiting often requires sticking something into the throat, which can also cause further damage. The strong physical reaction to repeated vomiting can contribute to tears in the GI tract, which can be very dangerous.1,2
Common upper GI complications from bulimia
Repeated self-induced vomiting can result in a number of gastrointestinal symptoms and complications in the respiratory system. Some of the most common complications include:1,2,3
- Loss of gag reflex
- Difficulty swallowing
- Oral, dental, and gum disease, decay, and ulceration
- Acid reflux
- Gastroesophageal reflux disease (GERD)
- Esophageal dysmotility, or muscle damage which, can cause food to become stuck in the esophagus
- Abdominal pain, spasms, and bloating
- Blood-stained vomit (hematemesis) from micro-tears in the esophagus
These are not the only complications that can arise from purging behavior. If you or a loved one are experiencing these or other GI issues, seeking appropriate medical care is important.
The most dangerous effects of bulimia on the GI system
BN can also cause some gastrointestinal manifestations that are less common but more severe and potentially even life-threatening.
Mallory-Weiss syndrome occurs when chronic vomiting leads to significant tears in the esophageal lining.2 This can result in vomiting blood, which is not only psychologically disturbing but, in extreme cases, can be life-threatening if the bleeding is not controlled.8
Bulimia nervosa has also been tied to an increased risk of developing esophageal adenocarcinoma, or cancer of the esophagus.6 The issue is once again tied to stomach acid in the esophagus.
When consistently present in the area, stomach acid can erode tissue in the lower esophageal sphincter, a valve that separates the esophagus from the stomach. Eventually, this can lead to permanent changes in the cells that line the lower esophageal sphincter, called Barrett’s esophagus. If left untreated, this can develop into esophageal cancer.4,6
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Respiratory tract damage caused by bulimia
The repeated vomiting involved in many types of bulimia nervosa can also lead to medical complications in the respiratory tract. Again, these can range from mild to life-threatening, but typically, symptoms tend to get worse the longer someone struggles with BN.
If someone accidentally chokes while vomiting, the vomit can aspirate into the lungs, introducing stomach fluid to that part of the body, including specific flora (bacteria) that aid in digesting food. While this flora is safe within the stomach, it can cause serious issues in the respiratory tract. These enzymes are designed to digest food but can work to eat away at the lining of the respiratory tract when introduced to that environment.5
Gastric acid can also cause severe chemical burns within the respiratory tract. Sometimes called a flash burn, this type of damage not only causes pain but can also cause an inflammatory response from the immune system. This response can, in turn, cause fluid to accumulate in the lungs, making breathing difficult.5
The respiratory tract is a small tube that does not contain excess room for tissue swelling. If damage is severe enough, the tissue can swell to the point of complete obstruction and suffocation. The obstruction, burn, and impending infection can result in acute respiratory distress syndrome (ARDS) that requires immediate intubation and ICU care.5
Warning signs of bulimia throat damage
While bulimia throat damage can develop into serious medical concerns, it doesn't necessarily start that way.
The damage caused by repeatedly throwing up can start out looking or feeling like:2
- Indigestion
- Heartburn
- Blood in vomit (even small amounts)
- Sores in the corners of the mouth
- Hoarse voice
- Frequent sore throat
- Enlarged salivary glands, which look like puffy cheeks
- Russell's sign, or cuts, calluses, or bruises on the hand or knuckles
If you or a loved one are experiencing these or other persistent symptoms of bulimia throat damage, it's important to seek treatment.
Strategies to prevent bulimia esophagus damage
Some strategies may help minimize the damage to the throat and respiratory system caused by BN or frequent vomiting.
Certain medications can help with GI discomfort, including heartburn or GERD. Many over-the-counter medications can treat these symptoms, though more frequent or severe cases may require stronger medication prescribed by a physician.9
Other strategies can help manage damage done to oral health. Flouride treatments and waiting after vomiting to brush one's teeth can help reduce tooth decay and other types of oral damage.10
Still, by and large, the best way to prevent bulimia esophagus damage is to treat bulimia nervosa directly.
Treating bulimia nervosa
Though they manifest as a number of physical ailments, eating disorders are complex mental health disorders, and appropriate treatment often includes a comprehensive approach, incorporating mental and behavioral therapy, nutrition-based education, and other treatment strategies.
Remote treatment is available
At Within, we understand and honor the complexity of these conditions. We hire a diverse team of professionals who can help with all aspects of bulimia nervosa and other eating disorders. Our virtual treatment program makes that care more accessible, regardless of geographic location or other social commitments.
Call us today
If you or a loved one are struggling with the effects of bulimia nervosa on your esophagus or respiratory system, treating the condition at the heart of the problem is the best solution to a healthier and happier future. And with the help of competent healthcare professionals, that type of recovery is always possible.
