Forced Vomiting: Peripheral Damage and Health Risks

Self-induced vomiting (purging) causes direct trauma to upper GI and oral structures, plus systemic metabolic derangements.

Local Tissue Damage

• Esophagus: Esophagitis, Mallory-Weiss tears (mucosal lacerations at GE junction), Boerhaave syndrome (full-thickness rupture—emergency).
• Teeth/oral cavity: Acid erosion → enamel loss, dentin hypersensitivity, caries; mucosal irritation.
• Salivary glands: Sialadenitis (swelling, pain, reduced flow).
• Musculoskeletal: Abdominal/chest wall muscle strain or tears.

Systemic Complications

• Electrolyte imbalances: Hypokalemia, hyponatremia, hypochloremia → arrhythmias, muscle weakness, seizures.
• Metabolic alkalosis: Loss of gastric acid.
• Dehydration: Hypovolemia, orthostasis, renal impairment.
• Vitamin/mineral deficiencies: Malabsorption from rapid transit.

Eating Disorder Context

In bulimia nervosa, chronic purging compounds these risks, leading to severe dental, GI, cardiac, and renal sequelae.

Action

Seek medical and psychiatric evaluation. Treatment: CBT-E, nutritional rehab, electrolyte correction, SSRIs. Early intervention improves recovery.