By: Jessica Cushing-murray
Though most people can understand the serious health consequences that can arise from a long term eating disorder, many are unaware of which problems are most commonly seen. One of which is called a Mallory Weiss Esophageal Tear, or Mallory Weiss Syndrome (MWS). MWS is defined as “tears in the lining of the esophagus,” which can often result from prolonged, severe vomiting, and is thus most evident in those suffering from Bulimia Nervosa.
So what exactly causes MW tears?
In people diagnosed with bulimia, the constant and continual act of forcing oneself to vomit (purge) their food after eating causes trauma to the esophagus (the tube that carries your food from your throat to your stomach). This trauma from vomiting can tear the lining of the esophagus, ultimately leading to people developing symptoms ranging from abdominal pain, to black/bloody bowel movements (blood in feces), to hematemesis (vomiting blood). None of these symptoms sound particularly pleasant, and they are worsened if the compulsive vomiting does not stop.
How can MW tears be fixed?
In people with bulimia who feel compelled to purge themselves through vomiting it can be unlikely that the Mallory Weiss tears in the esophagus will heal on their own. This creates an even more serious condition in which endoscopic therapy or even surgery may be required to resolve the symptoms. Left unhealed, MWS can lead to bad infections, as bacteria enter the open wounds in the esophagus. Though MWS can be the result of other trauma to the chest/throat, severe or prolonged hiccups, gastritis (inflammation of the stomach lining), it is a good example of a real and applicable consequence to people suffering from bulimia nervosa. However, it is possible that MW tears heal on their own, and a major part of the healing process is to stop purging behaviors.
For people with eating disorders (ED), it can become difficult to understand how their actions in their ED might affect them in the long run, so it’s important to learn and educate those around you about these kinds of conditions. Living with and recovering from an ED is difficult enough, it doesn’t need to be exacerbated by health issues such as MWS.
If you need help reducing your bulimia behaviors, including purging, make sure to reach out to an eating disorder registered dietitian for help. It can save your life (plus make food enjoyable again).
Lately I have seen an uptick in clients who “look” fine on the outside need urgent medical care. This got me thinking about the lies that the eating disorder voice (“Ed” for short) tells us.
Ed wants to be in control (which is funny because most people with eating disorders think they are in control. Silly humans.) and will tell you lies to keep up the disease process.
Have you ever hear the voice in your head say:
“You’re not thin enough yet.”
“You are not sick enough/you're not as sick as [other person].”
“Your heart rate is so low because you work out so much”
“You’re doing fine, you can [insert ED behavior] more [often/more strictly]”
“You’re the exception to the complications, it won't happen to you.”
Or something similar?
These are often precursors to the downfall of health.
Recently, I saw someone who had been dealing with bulimia on top of being an athlete have such low iron that she needed an immediate blood transfusion in the emergency room (Thank you to the doctor I work closely with for catching that!). I had another client peeing reddish urine with a “puffy” body that she said was hot to the touch that we believe is doing damage to her kidneys (or maybe experiencing rhabdomyolysis) from restricting (she ended up in higher-level care). Another is having severe gastrointestinal issues that are most likely due to years of laxative abuse and restricting that was misdiagnosed as “gastroparesis” until she finally saw a specialist.
The thing that all of these clients had in common? They said they were “fine” and didn’t need to go to the doctor. They weren’t “that bad” in their ED behaviors.
This is what scares me. How many people are walking around with medical issues that they have become so used-to that it feels normal?
PSA: Tell all of your providers from primary care physician, to specialists to therapists and dietitians about your eating disorder. Yes, even if you haven’t told anyone else. We can’t help you if we don’t know what is going on, and some providers won’t ask.
If you are struggling with disordered eating please take this as your sign to make sure you are getting regular check-ups from medical professionals that understand eating disorders and the hidden dangers. It can save your life.
Don’t wait to seek help. You have to be your own health advocate.
Libby is a non-diet Registered Dietitian focusing on eating disorder treatment and prevention. She approaches health from the inclusive standpoint that any "body" can focus on health regardless of size. She is a ally in diversity.
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