Why does bulimia cause broken blood vessels?

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Attempts at vomiting put extra pressure on the blood vessels of the face and eyes and can cause them to burst in individuals who have bulimia nervosa (BN). The rich supply of blood and dense network of tiny blood vessels just under the skin’s surface of the face make the delicate skin around the eyelids a vulnerable site for the rupture of thin blood vessels.

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Where do the blood vessels break in those with bulimia?

Repeated purging due to bulimia may cause blood vessels in the eyes, eyelids, and surrounding tissue on the face to break. Bulimia broken blood vessels may also occur on the neck. 

These show up as very small dots on the skin surrounding the entire eye. These dots are irregular and cannot be felt as a raised area on the skin. They are purplish in color. (1)

Other side effects specific to purging

Purging may seem like it’s over once the bout is finished, but that’s when the side effects start. 

Here’s are some problems that can happen as a result: (2)

  • Feeling faint – this is from the loss of electrolytes
  • Tooth decay – this results from the regurgitated stomach acids that contact the teeth
  • Nutritional deficiencies – because the foods eaten never make it to the internal organs 
  • Dehydration – because water is one of the fluids used in the process of regurgitation
  • GERD – this is also known as acid reflux 
  • Throat swelling – from the actual purging process
  • Facial swelling – from the actual purging process
  • Mood swings – from the rapid change of the body’s nervous system from sympathetic fight or flight to parasympathetic (back to normal) and nutritional deficits
  • Irregular heartbeat – from electrolyte imbalances
  • Other heart problems – from electrolyte and mineral imbalances
  • Complications if you become pregnant

What type of recovery times can be expected?

Recovery times of each of these side effects varies. Below is an average estimate of how long recovery is expected to take:

Broken blood vessels

Broken blood vessels from bulimia generally recover in 2-3 weeks. However, this may take longer if there is not enough protein or vitamin C consumption, because collagen and vitamin C are needed to produce new blood vessels. 

Feeling faint

You can recover from feeling faint in 1-2 days, if electrolyte replacement formula is used, or you can experience immediate recovery if taken to an emergency room for treatment. 

Tooth decay

To date, it is exceptionally difficult to regenerate enamel on the teeth. It’s the enamel that suffers erosion after purging. Because of this, teeth must be bonded with new polymers or veneers added. This is a very costly process, up to $15,000. However, new advancements in science using stem cells may bring better results. (3)

Nutritional deficiencies

It takes months for nutritional deficiencies to return to normal levels. Intravenous treatments, which are expensive, may be needed, but they do not include all nutrients. Expect a turnaround time of 12 to 24 months for all levels to return to normal, with blood and hair test monitoring to confirm they are normal. Monthly costs could be $300 for supplements and another $200 for testing.

Dehydration

If taken to the emergency room, dehydration will be taken care of with oral or IV replacement fluids.

Gastroesophageal reflux disease (GERD)

With correct treatment protocols, it may take 6 to 8 weeks to recover. But GERD could continue for years without the proper diagnosis and treatment.

Throat and Facial swelling

Recovery from both throat and facial swelling caused by bulimia nervosa generally clear up in 2-4 weeks. 

Mood swings

Recovery from mood swings can greatly vary. If mood swings are due to the nutrient deficiencies – B vitamins, vitamin D3, vitamin C, calcium, magnesium, and amino acids, it will take 2 to 3 months to stop them, if the correct supplements are taken. However, this is assuming that purging has stopped and there have been no relapses. 

Irregular heartbeat

Since an irregular heartbeat occurs from electrolyte imbalances, it can be eliminated in the emergency room with the proper treatment of electrolytes. 

Other heart problems

Other heart problems can range in how long they take to recover, depending on the severity.  The whole heart may need specialized treatment, which should result in progress within three months. Without treatment, heart medication may be necessary.

Treatment for purging eating disorders

Treatment for purging eating disorders, like bulimia nervosa, must include highly specialized medical, nutritional, and psychiatric protocols simultaneously to address all facets of this very complex eating disorder. But recovery from bulimia is possible. And the very first step of recovery is to seek help.

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. Agrawal M, Yadav P, Kumari R, Chander R. Eyelid petechiae as a window to relapse in a case of purging-type anorexia nervosa. Indian Journal of Psychiatry. 2019 Jan-Feb;61(1):101-102. doi: 10.4103/psychiatry.IndianJPsychiatry_107_18. PMID: 30745664; PMCID: PMC6341913 
  2. Sutton, J. (2019, February 21). Purging disorder: Symptoms, treatments, and more. Healthline. Retrieved October 27, 2022, from https://www.healthline.com/health/eating-disorders/purging-disorder 
  3. Khorsandi, Jay, DDS. (2022, May 18). Is it possible to regrow teeth? Stem cell implants. Byte. Retrieved October 27, 2022, from https://www.byte.com/community/resources/article/can-you-regrow-your-teeth-stem-cell-implants/

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