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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bulimia nervosa, an eating disorder now recognized with increasing frequency, is receiving growing attention because of purported complications. Recent claims of a high frequency of erosions, ulceration, and bleeding in the esophagus, ascribed to repeated, self-induced vomiting, prompted us to investigate by endoscopy the upper gastrointestinal mucosa in 37 consecutive patients with long-standing bulimia nervosa. The endoscopic appearance of esophageal and gastric mucosa was normal in 23 patients. Signs of mild esophagitis observed in eight patients were not related to the duration or severity of bulimic behavior or to symptoms of gastroesophageal reflux; two of these eight patients had sliding hiatal hernias. The remaining six patients were found to have superficial mucosal erythema in the stomach or duodenum, but none showed actual erosions, ulcers, or bleeding. Our observations suggest that, in contrast to reports by others, mucosal injury consequent to chronic, self-induced vomiting in patients with bulimia nervosa is relatively infrequent and limited.
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PMID:Upper gastrointestinal endoscopy findings in patients with long-standing bulimia nervosa. 259 94

It is well known that acid regurgitated from the stomach into the mouth will erode teeth. Conditions such as anorexia and bulimia nervosa, chronic alcoholism and gastric disturbances cause palatal dental erosion. The common factor in these conditions is the role played by the stomach and oesophagus in the acid movement. Acid moving through the lower oesophageal sphincter into the oesophagus is described as gastro-oesophageal reflux (GOR). In some patients the acid movement becomes chronic, painful and requires treatment and is termed gastro-oesophageal reflux disease (GORD). It is felt by many gastroenterologists that GORD is a failure of the anti-reflux mechanism, which is predominantly controlled by the lower oesophageal sphincter (LOS). Regurgitation is the reflux of gastric juice through the upper oesophageal sphincter and into the oral cavity. Once the acid has reached the mouth the potential exists for damage to the teeth. This paper reviews the role of GOR, GORD and regurgitation in the aetiology of dental erosion.
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PMID:The relationship between gastro-oesophageal reflux disease and dental erosion. 873 40

Dental erosion due to intrinsic factors is caused by gastric acid reaching the oral cavity and the teeth as a result of vomiting or gastroesophageal reflux. Since clinical manifestation of dental erosion does not occur until gastric acid has acted on the dental hard tissues regularly over a period of several years, dental erosion caused by intrinsic factors has been observed only in those diseases which are associated with chronic vomiting or persistent gastroesophageal reflux over a long period. Examples of such conditions include disorders of the upper alimentary tract, specific metabolic and endocrine disorders, cases of medication side-effects and drug abuse, and certain psychosomatic disorders, e.g. stress-induced psychosomatic vomiting, anorexia and bulimia nervosa or rumination. Based on a review of the medical and dental literature, the main symptoms of all disorders which must be taken into account as possible intrinsic etiological factors of dental erosion are thoroughly discussed with respect to the clinical picture, prevalence and risk of erosion.
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PMID:Etiology of dental erosion--intrinsic factors. 880 85

Diet analysis and advice for patients with tooth wear is potentially the most logical intervention to arrest attrition, erosion and abrasion. It is saliva that protects the teeth against corrosion by the acids which soften enamel and make it susceptible to wear. Thus the lifestyles and diet of patients at risk need to be analysed for sources of acid and reasons for lost salivary protection. Medical conditions which put patients at risk of tooth wear are principally: asthma, bulimia nervosa, caffeine addiction, diabetes mellitus, exercise dehydration, functional depression, gastroesophageal reflux in alcoholism, hypertension and syndromes with salivary hypofunction. The sources of acid are various, but loss of salivary protection is the common theme. In healthy young Australians, soft drinks are the main source of acid, and exercise dehydration the main reason for loss of salivary protection. In the medically compromised, diet acids and gastroesophageal reflux are the sources, but medications are the main reasons for lost salivary protection. Diet advice for patients with tooth wear must: promote a healthy lifestyle and diet strategy that conserves the teeth by natural means of salivary stimulation; and address the specific needs of the patients' oral and medical conditions. Individualised, patient-empowering erosion WATCH strategies; on Water, Acid, Taste, Calcium and Health, are urgently required to combat the emerging epidemic of tooth wear currently being experienced in westernised societies.
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PMID:Tooth wear: diet analysis and advice. 1588 Sep 60

Bulimia nervosa and other eating disorders have been on the increase for the past half century. Self-induced vomiting is often practiced as a method of weight control in these patients, potentially causing acidic damage to the esophagus of the kind observed in cases of gastroesophageal reflux disease. To ascertain whether patients suffering from bulimia nervosa had an increased rate of reflux-related symptoms, potentially placing them at risk of developing sequelae such as Barrett's esophagus and esophageal adenocarcinoma, a literature review was performed via searches of databases including PubMed, Medline, OVID and PsycINFO and a recursive search of the literature. The search terms were: bulimia nervosa; reflux; esophageal adenocarcinoma; Barrett's esophagus; eating disorders; oral; dental; complications. Several case reports were identified detailing the occurrence of an esophageal tumor in patients with a history of bulimia. This was supported to some degree by studies detailing higher incidences of reflux symptoms in eating disordered patients compared to controls but there was large variability in study design, quality and results. From these results an association is suggested as possible but is far from being proved conclusively. Further investigation is required using larger patient groups, better study design controlling for confounding factors and symptom characterisation.
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PMID:Gastroesophageal reflux disease and bulimia nervosa--a review of the literature. 2065 42

Acid reflux, which is the entry of acidic gastric contents into the upper gastrointestinal tract, may manifest as two clinical syndromes-gastroesophageal reflux and/or laryngopharyngeal reflux. The latter syndrome, laryngopharyngeal reflux, is associated with the symptom of hoarseness. In the literature on eating disorders, according to general articles on medical complications, case reports, review articles on reflux, and empirical research, patients with self-induced vomiting (e.g., anorexia nervosa binge-eating purging type, bulimia nervosa purging type) are at risk for acid reflux, potentially culminating in either reflux syndrome. Because of the unique voice effects encountered with laryngopharyngeal reflux, hoarseness may be an indistinct clinical indicator of an eating-disorder syndrome characterized by self-induced vomiting-particularly when present in a young female of normal weight or underweight status. Thus, hoarseness in young women may suggest an eating disorder, both in psychiatric and primary care settings.
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PMID:Hoarseness: a sign of self-induced vomiting? 2319 76

Bulimia nervosa is an eating disorder characterized by consuming a large amount of food in a short amount of time followed by an attempt to rid oneself of the food consumed (purging), typically by vomiting, taking a laxative, diuretic, or stimulant, and/or excessive exercise, because of an extensive concern for body weight. The frequent contact between teeth and gastric acid, in particular, may cause: severe dental erosion, perimolysis, or the erosion of tooth enamel and swollen salivary glands. Constant vomiting can lead to gastroesophageal reflux. The aim of this article is to report two cases of patients with severe dental demineralization associated with bulimia nervosa during orthodontic treatment. Diagnosis and prevention aspects are highlighted and discussed.
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PMID:Dental white spots associated with bulimia nervosa in orthodontic patients. 2442 44

Barrett's esophagus (BE) is a metaplastic lesion that may result from long-lasting gastroesophageal reflux and it is an established precursor of esophageal adenocarcinoma. There are reports of an increased prevalence of BE, and eventually esophageal adenocarcinoma, in patients with eating disorders characterized by purging behaviors like those with bulimia nervosa (BN). Among patients with eating disorders, those affected by anorexia nervosa binging purging subtype (ANBP), are behaviorally very similar to those with BN, but to our knowledge there are no data in literature about BE in patients with ANBP. We present the case of a 37-year-old female with a 20-year history of ANBP in comorbidity with bipolar disorder, who developed a BE requiring multi-specialistic intervention.
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PMID:Barrett's esophagus in anorexia nervosa: a case report. 2475 36

The two most clinically serious eating disorders are anorexia nervosa and bulimia nervosa. A drive for thinness and fear of fatness lead patients with anorexia nervosa either to restrict their food intake or binge-eat then purge (through self-induced vomiting and/or laxative abuse) to reduce their body weight to much less than the normal range. A drive for thinness leads patients with bulimia nervosa to binge-eat then purge but fail to reduce their body weight. Patients with eating disorders present with various gastrointestinal disturbances such as postprandial fullness, abdominal distention, abdominal pain, gastric distension, and early satiety, with altered esophageal motility sometimes seen in patients with anorexia nervosa. Other common conditions noted in patients with eating disorders are postprandial distress syndrome, superior mesenteric artery syndrome, irritable bowel syndrome, and functional constipation. Binge eating may cause acute gastric dilatation and gastric perforation, while self-induced vomiting can lead to dental caries, salivary gland enlargement, gastroesophageal reflux disease, and electrolyte imbalance. Laxative abuse can cause dehydration and electrolyte imbalance. Vomiting and/or laxative abuse can cause hypokalemia, which carries a risk of fatal arrhythmia. Careful assessment and intensive treatment of patients with eating disorders is needed because gastrointestinal symptoms/disorders can progress to a critical condition.
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PMID:Gastrointestinal symptoms and disorders in patients with eating disorders. 2649 70

During the last decades, an increasingly greater interest in dental erosion has been observed in clinical dental practice, in dental public health and in dental research because prevalence of erosive tooth wear is still increasing especially in young age group of population. Erosive tooth wear is a multifactorial etiology process characterized by progressive loss of hard dental tissue. It is defined as the exogenous and/or endogenous acids dissolution of the dental tissue, without bacterial involvement. In the development of dental erosive wear, interactions are required which include chemical, biological, behavioral, diet, time, socioeconomic, knowledge, education, and general health factors. Examples of risk groups could be patients with eating disorders, like anorexia nervosa or bulimia nervosa, gastroesophageal reflux disease, chronic alcohol abuse or dependence. Special nutrition habits groups with high consumption of soft or sport drinks, special diets like vegetarian, vegan or raw food diet, the regular intake of drugs, medications and food supplements can also increase the risk for dental erosion. Comprehensive knowledge of the different risk and protective factors is a perquisite for initiating adequate preventive measures.
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PMID:[Tooth erosion - a multidisciplinary approach]. 2700 Aug 9


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