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Purging-Type Bulimia Nervosa

Purging Type Bulimia Nervosa


Presentation

  • […] in 80-90% of individuals who present for treatment,7 and therefore this section describes the health state of an individual with bulimia nervosa, purging type.[acronymattic.com]
  • Case presentation We present as our main case a 20-year-old Japanese woman with anorexia nervosa who engaged in “tube vomiting.”[ncbi.nlm.nih.gov]
  • A diagnosis might then be allocated that specifies a specific reason why the presentation does not meet the specifics of another disorder (e.g. Bulimia Nervosa- low frequency).[freedeatingdisorders.org]
Developmental Disabilities
  • […] need for an overview of the most current issues and changes in the field, allowing readers to: Review the development, theories, and influences in child and adolescent psychopathology Understand neurodevelopmental disorders including intellectual and developmental[books.google.com]
  • Rumination Disorder The prevalence of rumination disorders is unknown, but is certainly higher in patients with developmental disabilities.[clevelandclinicmeded.com]
Vomiting
  • The baselines of both groups were comparable with regard to key features, including binge and vomiting frequency, and carbohydrate and lipid intake.[ncbi.nlm.nih.gov]
  • […] uses other methods of compensation, such as fasting or excessive exercise, but does not regularly engage in self-induced vomiting or the use of laxatives, diuretics, or enemas. 7- Self-induced vomiting is the most common method to compensate for binge[acronymattic.com]
  • In the BN-NI group, six patients did only self-induced vomiting, one did only laxative abuse, two did self-induced vomiting and laxative abuse, and, of the two patients without self-induced vomiting or laxative abuse, one did vigorous exercise and the[care.diabetesjournals.org]
Nausea
  • […] non-draft ICD-10-CM) 2017 (effective 10/1/2016) : No change 2018 (effective 10/1/2017) : No change 2019 (effective 10/1/2018) : No change Code annotations containing back-references to F50.2 : Type 1 Excludes: R11, R63, F50.02 ICD-10-CM Diagnosis Code R11 Nausea[icd10data.com]
  • Self-induced vomiting, misuse of laxatives, diuretics, and enemas Excessive exercising, fasting, or dieting Eating so much that it results in stomach pain Fluctuating weight – going up and down Gastrointestinal problems – diarrhea, gas, constipation, nausea[psycom.net]
  • Gastric rupture, the most serious complication, is uncommon. 17 More often, patients describe nausea, abdominal pain and distention, prolonged digestion and weight gain.[aafp.org]
  • When the patient is regurgitating previous swallowed food this might be partially digested and patient is not having nausea or involuntary retching.[clevelandclinicmeded.com]
Binge-Eating/Purging Type of Anorexia Nervosa
  • eating purging type Anorexia nervosa, binge eating purging type, extreme Anorexia nervosa, binge eating purging type, in full remission Anorexia nervosa, binge eating purging type, in partial remission Anorexia nervosa, binge eating purging type, mild[icd10data.com]
  • Bulimia nervosa is different than the binge eating/purge type of anorexia nervosa in a few ways. Someone struggling with BN does not restrict, is not necessarily underweight, and often recognizes there is a problem.[eatingdisorderfoundation.org]
Hematemesis
  • .- ) hematemesis ( K92.0 ) neonatal hematemesis ( P54.0 ) newborn vomiting ( P92.0- ) psychogenic vomiting ( F50.89 ) vomiting associated with bulimia nervosa ( F50.2 ) vomiting following gastrointestinal surgery ( K91.0 ) ICD-10-CM Diagnosis Code R63[icd10data.com]
  • […] fat 10% Refusal to eat Failure to respond to outpatient treatment Bulimia nervosa Syncope Serum potassium 3.2 mmol/L Serum chloride 88 mmol/L Esophageal tears Cardiac arrhythmias including prolonged QTc Hypothermia Suicide risk Intractable vomiting Hematemesis[aafp.org]
  • […] in oral intake or weight despite maximally intensive outpatient interventions Prior knowledge of weight at which physical instability is likely to occur in the particular patient Serious physical abnormalities Electrolyte or metabolic abnormalities Hematemesis[clevelandclinicmeded.com]
Recurrent Vomiting
  • The circulatory system is affected in that recurrent vomiting, which can cause dehydration, weak muscles or fatigue. The weakened heart muscles can cause an erratic heartbeat, leading to heart failure in severe cases.[therecoveryvillage.com]
  • vomiting washes mouth with acid and stomach enzymes; mineral deficiencies Edema Laxative abuse, hypoproteinuria, electrolyte imbalances Parotid gland enlargement Gastric acid and enzymes from vomiting cause parotid inflammation Scars or calluses on fingers[aafp.org]
Orthostatic Hypotension
  • Consider admission for persistent and recurrent emesis alone (10 to 20 times a day), especially in the face of bradycardia or orthostatic hypotension.[acphospitalist.org]
  • Bradycardia, orthostatic hypotension, and palpitations may progress to potentially fatal arrhythmias. Epigastric pain and a bloating sensation are common. Laxative abuse causes hemorrhoids and rectal prolapse.[aafp.org]
  • hypotension and heart rate less than 40 beats per minute or greater than 110 beats per minute Inability to sustain body core temperature Comorbid psychiatric illness (suicidal, depressed, unable to care for self) Based on information from references[clevelandclinicmeded.com]
Dental Caries
  • caries Electrolyte abnormalities Gastrointestinal irritation, bleeding, or reflux Parotid abnormalities Secondary renal failure Based on information from references 35-38.[clevelandclinicmeded.com]
Low Self-Esteem
  • They either have an intense fear of gaining weight, a strong desire to lose weight, or a significant impairment in their body image, which is often noted by low self-esteem.[centerfordiscovery.com]
  • Low self-esteem: Women or men who think of themselves as useless, worthless, and unattractive are at risk for bulimia. Things that can contribute to low self-esteem include depression, perfectionism, childhood abuse, and a critical home environment.[soulutionscounselling.com]
  • Low self-esteem, irritability and mood swings, and feelings of guilt, shame, and anxiety, especially after a binge, are also common.[beateatingdisorders.org.uk]
  • Left unchecked, it can to lead to metabolic disorders, low self-esteem, depression, or even death. It is therefore, important to seek treatment for this complex and dangerous form of bulimia, and the emotional issues that accompany it.[eatingdisorders.com]
  • Other contributing factors include: low self-esteem, impulsive behavior, problems managing anger, relationship conflicts and society’s focus on thinness.[ulifeline.org]
Preoccupation with Food
  • Their preoccupation with food and weight may become an obsession that severely impacts what and how they eat. They will create extreme rules and restrictions about their diets, and some people with anorexia may binge eat and then purge.[healthdirect.gov.au]
  • Warning Signs of Anorexia Nervosa Preoccupation with body shape, weight and/or appearance Intense fear of gaining weight Preoccupation with food or food related activities Negative or distorted body image; perceiving self to be fat when at a healthy weight[eatingdisorders.org.au]
  • For example, starvation increases preoccupation with food and the risk of binge-eating. For underweight patients, achievement of a low normal weight is therefore a priority for successful treatment.[hopkinsmedicine.org]
  • […] with food, weight, and body shape Scarring on the back of the fingers from the process of self-induced vomiting Overachieving behaviors The symptoms of bulimia may resemble other medical problems or psychiatric conditions.[stanfordchildrens.org]
Sexual Dysfunction
  • The individual may eventually become socially withdrawn and may experience somatic/sexual dysfunction, particularly in severely underweight individuals.[www150.statcan.gc.ca]
Seizure
  • In addition to anorexia, a number of disorders may mimic bulimia, including: borderline personality disorder brain tumors depression epileptic seizures Klein-Levin syndrome (a rare condition more common in men that causes excessive eating) Kluver-Bucy[psychiatric-disorders.com]
  • Paresthesias, tetany, seizures or cardiac arrhythmias are potential metabolic complications that require acute care. 17 Chemistry profiles should be obtained regularly in patients who continue to vomit or abuse purgatives on a regular basis.[aafp.org]
  • Malnutrition (can lead to loss of muscle and bone density [osteoporosis] resulting in dry, brittle bones) Severe dehydration, which can result in kidney failure and chemical imbalances (can lead to seizures, irregular heartbeats and possibly heart failure[disabled-world.com]
  • Doses of tricyclic antidepressants and monoamine oxidase inhibitors parallel those used to treat depression, but higher doses of fluoxetine ( 80 mg/day) may be needed to treat bulimia nervosa. 51 Bupropion (Wellbutrin) has been associated with seizures[clevelandclinicmeded.com]
Neglect
  • There seems to be a relationship between the high scores on psychological tests for perfectionism and the absence of insulin omission in BN-NI patients: 1 ) originally, most perfectionist patients are not likely to omit insulin because they cannot neglect[care.diabetesjournals.org]
  • This includes things such as sexual assault, childhood neglect or abuse, troubled family relationships, or the death of a loved one. Effects of bulimia When you are living with bulimia, you are putting your body—and even your life—at risk.[helpguide.org]
  • Patients under stressful situations such as neglect, stressful life, and problems in the relationship with the parents are certainly more frequent in infant and young children.[clevelandclinicmeded.com]
Behavior Problem
  • The rates of patients with severe medical and psychological/behavioral problems were the highest in the BN-IP group.[care.diabetesjournals.org]
  • Eating Disorders Also called: Anorexia nervosa, Binge eating, Bulimia Eating disorders are serious behavior problems. They can include severe overeating or not consuming enough food to stay healthy.[icdlist.com]
  • Other contributing factors include: low self-esteem, impulsive behavior, problems managing anger, relationship conflicts and society’s focus on thinness.[ulifeline.org]
  • Although eating disorders did not resolve, other behavioral problems did. There was less parental dissatisfaction as children developed better awareness and behavior patterns.[clevelandclinicmeded.com]
Forgetful
  • Each chapter features reader-friendly elements like Rapid Reference, Caution, and Don't Forget boxes that call out important information, facilitating easy look-up and quick navigation.[books.google.com]

Treatment

  • With its emphasis on treatment strategies, this text can be used by practitioners as well as by professors in the classroom in introductory courses in addictions or in subsequent courses that focus on treatment strategies.[books.google.com]
  • .: Psychoeducational principles in treatment. In: Garner D.M., Garfinkel P.E. (Eds.) Handbook of treatment for Eating Disorders. New York, Guilford, 1997, pp. 145–174. Google Scholar 6.[link.springer.com]
  • […] excessive exercise, but does not regularly engage in self-induced vomiting or the use of laxatives, diuretics, or enemas. 7- Self-induced vomiting is the most common method to compensate for binge eating, present in 80-90% of individuals who present for treatment[acronymattic.com]
  • Throughout the process of treatment of these patients, clinical characteristics were investigated in detail through interviews.[care.diabetesjournals.org]

Prognosis

  • . , perfectionism) may influence or be a consequence of anorexia nervosa. 109 Prognosis is improved with early detection and intervention.[www150.statcan.gc.ca]
  • Both are illnesses of the lung with cough and fever, but each will have a slightly different natural history, treatment, and, sometimes, prognosis.[kartiniclinic.com]
  • […] sodium) ð changes in nerve & muscle function Low blood pressure Slow heart rate Kidney & gastrointestinal problems Bone mass declines Skin dry & nails brittle Hair loss Death from life-threatening illness or suicide Eating Disorders - Anorexia Nervosa Prognosis[www2.hawaii.edu]
  • Prognosis: 1. The expected course of a disease. 2. The patient's chance of recovery. The prognosis predicts the outcome of a disease and therefore the future for the patient. His prognosis is grim, for example, while hers is good.[psychologistanywhereanytime.com]
  • Prognosis The outcome for individuals with eating disorders can be described by the rule of thirds. One-third of individuals improve, do well, and lead normal lives.[acphospitalist.org]

Etiology

  • […] studies show genetic contribution to anorexia & bulimia No evidence from adoption studies o Endogenous opioids may play role in bulimia o Hypothalamus regulates hunger and may be dysfunctional o Neurotransmitter serotonin may be deficient in bulimia Etiology[www2.hawaii.edu]
  • .: Etiology of Binge Eating: Biological mechanisms. In: Fairburn C.G., Wilson G.T. (Eds.) Binge Eating. Nature, Assessment and Treatment. New York, Guilford, 1993, pp. 206–224. Google Scholar 18.[link.springer.com]
  • Frequent vomiting has been reported to cause swelling of the salivary glands in approximately 8 percent of patients with bulimia nervosa. 20 The exact etiology is unknown.[aafp.org]
  • Definition and Etiology Eating disorders are syndromes characterized by severe disturbances in eating behavior and by distress or ex-cessive concern about body shape or weight and often occur with severe medical or psychiatric comorbidities.[clevelandclinicmeded.com]

Epidemiology

  • "Epidemiological studies on adverse dieting behaviours and eating disorders among young people in Hungary". Social Psychiatry and Psychiatric Epidemiology. 39 (8): 647–54. doi : 10.1007/s00127-004-0783-z. PMID 15300375.[en.wikipedia.org]
  • In disease epidemiology, the incidence is the number of newly diagnosed cases during a specific time period. The incidence is distinct from the prevalence which refers to the number of cases alive on a certain date.[psychologistanywhereanytime.com]
  • Smink FR, van Hoeken D, Hoek HW. epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 2012; 14:406–414. Carter JC, Mercer-Lynn KB, Norwood SJ, et al.[clevelandclinicmeded.com]
  • Epidemiology/Health Services/Psychosocial Research Abstract OBJECTIVE —To classify type 1 diabetic females with bulimia nervosa (BN) by type of inappropriate compensatory behavior in order to prevent weight gain (ICB) and to investigate the group differences[care.diabetesjournals.org]
  • Child sexual abuse and later disordered eating: a New Zealand epidemiological study. Int J Eat Disord, Vol. 29(4):380-92. Raffi AR, et al. Life events and prodromal symptoms in bulimia nervosa. Psychol Med, vol. 30(3):727-31. Webster JJ, et al.[consumer.healthday.com]
Sex distribution
Age distribution

Pathophysiology

  • The “pathophysiologic model” suggests that brain chemistry causes the disorder.[bulimiaguide.org]
  • The research in this field is continuously evolving, as is the current knowledge of pathophysiology, clinical recognition and inpatient management of NI and eating disorders.[acphospitalist.org]
  • Back to Top Pathophysiology and Natural History Biologic and psychosocial factors are implicated in the pathophysiology of eating disorders, but the underlying causes and mechanisms remain unknown. 7,18,19 Biologic Factors First–degree female relatives[clevelandclinicmeded.com]
  • “Eating disorders: clinical features and pathophysiology”. Physiol. Behav. 81 (2): 359–74.doi:10.1016/j.physbeh.2004.02.009. PMID 15159176 6. Douglas Harper (November 2001). “ Online Etymology Dictionary: bulimia “.Online Etymology Dictionary.[mirror-mirror.org]
  • Selected Clinical Signs of Eating Disorders Sign Underlying pathophysiology Anorexia nervosa Amenorrhea Hypothalamic dysfunction, low fat stores, malnutrition Arrhythmia Electrolyte disorders, heart failure, prolonged corrected QT interval Bradycardia[aafp.org]

Prevention

  • Insulin is often omitted for purposes of preventing weight gain, especially in young women, and has been discussed in relation to eating disorders ( 6 , 9 ).[care.diabetesjournals.org]
  • Marlatt A., Gordon J.: Relapse prevention. New York, Guilford, 1985. Google Scholar 15. Blundell J.E.: The biology of appetite. Clin. Appl. Nutr., 1, 21-31, 1991. Google Scholar 16.[link.springer.com]
  • He or she may be in a good position to identify early indicators of an eating disorder and help prevent its development.[mayoclinic.org]
  • Laxative and enema abuse Laxatives are medications used to treat or prevent constipation and are often inappropriately used to rid the body of calories of food.[centerfordiscovery.com]
  • Nonpurging bulimics use other compensatory behaviors including fasting and excessive exercise to prevent weight gain. The causes of bulimia nervosa are unclear.[ohioline.osu.edu]

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