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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 28-year-old woman manifested a hemorrhagic tendency caused by a deficiency of vitamin K-dependent coagulation factors. Her condition was diagnosed as bulimia nervosa in view of a previous history of anorexia nervosa and episodes of self-induced vomiting and purging. There were no remarkable lesions in her alimentary system. In treatment of bulimia nervosa, attention should be given not only to the loss of body fluids and electrolytes, but also to the possibility of a deficiency of vitamin K-dependent coagulation factors.
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PMID:Bulimia nervosa complicated by deficiency of vitamin K-dependent coagulation factors. 657 78

Bulimia (bulimia nervosa; binge eating) is characterized by episodic eating of large amounts of food, followed by self-induced vomiting or laxative abuse. Psychotherapy has been the mainstay of treatment and often has been unsuccessful. The similarity of bulimia to major depression has led to evaluation of antidepressant drugs for treatment of the disease. Imipramine has proven effective in reducing binging episodes, and further evaluation of antidepressants seems warranted. Phenytoin also has been effective in some cases, suggesting that bulimia may be a neurologic disorder analogous to epilepsy. Optimal treatment may be antidepressants combined with a nutrition/psychotherapy program.
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PMID:Treatment of bulimia. 658 Jan 31

Following a television documentary on bulimia nervosa, people who thought that they had this type of eating problem were asked to complete a confidential questionnaire. 579 women who fulfilled self-report diagnostic criteria for bulimia nervosa were thereby identified. These women closely resembled patients with bulimia nervosa, although the age range was wider. They had grossly disturbed eating habits and almost half vomited at least daily. Laxative abuse was also common. Although almost two-thirds had been overweight in the past, the majority had a weight within the normal range. A minority had previously fulfilled diagnostic criteria for anorexia nervosa. On standardized measures, these women had abnormal attitudes to their weight and shape, as well as significant levels of psychiatric symptomatology. Nearly three-quarters thought that they definitely needed professional help, yet only a third had ever been referred for psychiatric treatment. Using data from this sample and an independent sample of 499 probable bulimia nervosa cases, the significance of three issues relating to the diagnosis of bulimia nervosa were examined: laxative abuse, the frequency of self-induced vomiting, and a history of anorexia nervosa.
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PMID:Binge-eating, self-induced vomiting and laxative abuse: a community study. 658 99

Daily measurement of mood, and the occurrence of specific eating behaviours, were assessed concurrently over an eight-week period in a sample of 50 patients meeting diagnostic criteria for bulimia nervosa. Results of observer-rated scales of mood showed a significant reduction of scores, whereas self-assessment of mood showed no change over the study period. Negative mood states, although not severe, were more marked when the specific behavioural symptoms of binge-eating, vomiting, or purging occurred, and they increased as abnormal eating behaviours accumulated. It is suggested that the accompanying dysphoric mood states of bulimia nervosa are likely to be a secondary manifestation related to the presence of abnormal eating symptoms, and that they do no constitute a primary depressive illness.
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PMID:Mood changes in bulimia nervosa. 659 79

The prevalence of the syndromes bulimia and bulimia nervosa is not known. Although existing epidemiological studies have produced somewhat conflicting findings, it appears likely that these syndromes constitute a significant source of psychiatric morbidity. It is interesting to note that prior to 1980 there appear to have been few patients who fulfil diagnostic criteria for these syndromes, whereas since then the number of such patients seems to have greatly increased. Whilst it is possible that the recent publicity may have engendered new cases by suggesting that self-induced vomiting is an effective means of weight control, there are two other likely explanations for the increase. First, the publicity may have helped people with these conditions divulge their eating problems to doctors. Second, doctors may have been alerted to the fact that people with a normal body weight may nevertheless have an eating disorder which requires a specialist's help. If these explanations are correct, the upsurge in referrals may be a short-lived phenomenon during which existing cases of varying duration will come to attention. Thereafter, it would be predicted that the referral rate will decline to a level which more accurately reflects the incidence of the two conditions (22). The emergence of these syndromes is not simply of theoretical interest. They pose a challenging therapeutic problem which has necessitated the development of specific psychological approaches to their treatment. However, before any treatment for bulimia can be advocated, its use should be supported by data from controlled outcome studies in which changes in each facet of the condition are assessed including patients' eating habits, moods, and most importantly, their attitudes to their weight and shape. As has been discussed, behavioural improvement is likely to be short-lived unless it is accompanied by significant attitude change.
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PMID:Bulimia: its epidemiology and management. 660 92

Six hundred and twenty women who were currently practising self-induced vomiting to control their weight were identified with the help of a women's magazine. Nineteen women (3.1%) fulfilled diagnostic criteria for anorexia nervosa. Of the remainder, 499 (83.0%) fulfilled diagnostic criteria for bulimia nervosa, a recently described eating disorder. Of these, 56.1% practised self-induced vomiting at least once daily; the mean duration of vomiting was 4.5 years. Most women were of normal body weight. On standardised measures, 68.1% of women showed pronounced psychiatric morbidity and 89% had profoundly disturbed attitudes to food and eating. 56.4% thought they definitely needed medical help, though only 30.1% had ever discussed any aspect of their eating difficulties with a doctor. This study highlights the secrecy that surrounds bulimia nervosa and suggests that it is an important undetected source of psychiatric morbidity.
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PMID:Self-induced vomiting and bulimia nervosa: an undetected problem. 680 73

Bulimia nervosa is a psychological compulsive eating disorder that appears to be affecting a growing number of young women. It is characterized by repeated episodes of binge-eating followed by vomiting or some other purging behavior. Bulimia is accompanied by a number of physiological disturbances, some of which occur in the oral cavity. The present article reviews the major characteristics of bulimia nervosa, and describes the most significant oral manifestations of this disorder along with their reported incidences and etiologies.
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PMID:Oral manifestations of bulimia nervosa. 757 61

Phosphorus abnormalities among patients suffering from eating disorders, although cited, have received relatively little attention. Studies generally report decreased concentrations of phosphorus for both bulimia and anorexia nervosa. We have recently noted hyperphosphatemia in several consecutive hospitalized bulimic patients who appeared to have normal renal function and calcium levels. Case files of 30 inpatient and outpatient female bulimic patients and 30 sex- and age-matched physically healthy psychiatric inpatients and outpatients were reviewed. Phosphorus and electrolytes related to phosphorus metabolism were compared between the two groups. Twenty-four of 30 bulimic patients (80%) were found to have at least one elevated serum phosphorus concentration, whereas all but one of 30 age-matched controls had values within normal limits. Elevated phosphorus levels were generally in the mild to moderate range. No correlation was found between phosphorus levels and any of the other electrolytes examined in both patients and controls. No correlation was found between phosphorus levels and the reported frequency of bingeing and vomiting or the number of laxatives ingested. Since bulimic patients are generally of normal weight and tend to deny their disturbed eating habits, diagnosis is often delayed. However, bulimia may be suspected from biochemical abnormalities such as hypokalemia, hypochloremia, elevated amylase, and acid-base disturbances. This preliminary study indicates that elevated serum phosphorus levels may serve as an additional objective marker for the presence of bulimia nervosa.
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PMID:Hyperphosphatemia: an objective marker for bulimia nervosa? 764 49

Low ego strength is theoretically thought of as causing difficulties in interpersonal relations and leading to the development of psychiatric symptomatology. Patients with bulimia nervosa were previously shown to have low ego strength and were studied to investigate whether gains in ego strength occur over time and are associated with improvement in symptoms. The average patient had an ego strength at a borderline level at index and at a neurotic level 6 years later. Less positive change in ego strength was associated with a low initial Eating Disorder Inventory (EDI) Symptom score a long Time in Treatment, and having been referred for specialist care. Positive changers significantly more often stopped vomiting/abusing laxatives and showed several non-significant tendencies to improve in other symptomatic aspects as well. Several methodological caveats are discussed, but these findings may contribute to the identification of mechanisms whereby long-term improvement occurs in bulimia nervosa.
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PMID:Co-occurrence of ego function change and symptomatic change in bulimia nervosa: a six-year interview-based study. 767 Apr 40

The authors investigated the significance of vomiting for hyperamylasemia and sialadenosis in patients with bulimia nervosa. Hyperamylasemia was found in 61% of the bulimics and in 20% of the restrictor anorectics but in no patients with binge-eating syndrome. In more than three fourths of the bulimics there was a close positive correlation between the frequency of vomiting and total serum amylase levels. Both frequency and type of vomiting seem to be relevant to the extent of salivary gland enlargement. The significance of vomiting for the etiopathology of hyperamylasemia and for the diagnosis of eating disorders will be discussed.
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PMID:Significance of vomiting for hyperamylasemia and sialadenosis in patients with eating disorders. 768 85


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