the Risks of Induced Vomiting: When to Seek Medical Help

Frequent vomiting?

Hello Doctor, I have been experiencing body image anxiety and have been inducing vomiting for the past 6-7 years, although not daily—it's been intermittent.
I had stopped for about a year or two, but recently it has resumed, occurring about once every two weeks.
This week, I've noticed that I feel nauseous and have a slight stomach ache when I go to work on an empty stomach (though the frequency is low).
After vomiting this time, my throat feels strange, and there are some blood streaks in the mucus.
I would like to know if I need to undergo an endoscopy.
Thank you, Doctor.
🙏🏻🙏🏻

211, 20~29 year old female. Ask Date: 2023/05/21

Dr. Hu Guozheng reply Gastroenterology and Hepatology

Consideration is possible, but the primary focus should be on addressing the anxiety-related vomiting behavior.

Reply Date: 2023/05/21

More Info

Induced vomiting, often associated with eating disorders such as bulimia nervosa, can lead to a variety of serious health risks and complications. Given your history of inducing vomiting for 6-7 years, it’s crucial to understand the potential consequences and when to seek medical help.

Firstly, frequent vomiting can cause significant damage to the esophagus, throat, and teeth. The stomach acid that is expelled during vomiting can erode the lining of the esophagus, leading to conditions such as esophagitis, which is inflammation of the esophagus. This can result in symptoms like pain when swallowing, difficulty swallowing, or a sensation of food getting stuck. Additionally, the acid can cause dental erosion, leading to cavities and other dental issues.

The presence of blood in your throat secretions is particularly concerning. Blood can indicate several issues, including:
1. Esophageal Tears (Mallory-Weiss Syndrome): Forceful vomiting can cause tears in the esophagus, leading to bleeding.

2. Gastritis: Inflammation of the stomach lining can occur due to the repeated exposure to stomach acid, which may also lead to bleeding.

3. Ulcers: Chronic irritation from acid can lead to the development of ulcers in the stomach or esophagus, which can also bleed.

The symptoms you describe—nausea, occasional stomach pain, and the presence of blood—warrant a medical evaluation. It is advisable to seek medical attention promptly, especially since you have a history of induced vomiting. A healthcare provider may recommend an upper gastrointestinal (GI) endoscopy (gastroscopy) to visually inspect the esophagus, stomach, and the first part of the small intestine. This procedure can help identify any damage, inflammation, or bleeding sources.

In addition to physical health concerns, it’s essential to address the underlying issues related to body image and the compulsion to induce vomiting. Eating disorders are complex and often require a multidisciplinary approach for treatment, including psychological support, nutritional counseling, and medical care. Therapy can help you develop healthier coping mechanisms and address the anxiety related to body image.

If you are experiencing increased nausea, stomach pain, or any other concerning symptoms, do not hesitate to seek medical help. It’s better to err on the side of caution, especially with a history of induced vomiting. Early intervention can prevent more severe complications and help you on the path to recovery.

In summary, given your symptoms and history, it is highly recommended that you consult with a healthcare professional. They can provide a thorough evaluation and determine the appropriate next steps, including whether an endoscopy is necessary. Additionally, consider seeking support for the underlying issues related to your body image and eating behaviors, as this is crucial for your overall health and well-being.

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