Medical treatment
The many medical complications of Bulimia Nervosa which can lead to Anorexia Nervosa are treatable. Much of the treatment evidence,; however, is derived from clinical experience rather than clinical trials according to a 2011 literature review of current medical complications and treatments of Bulimia Nervosa (Mehler, 2011).
Treatment of Oral Complications
Caries - For prevention of caries it is recomended that an individual gently brush and use a flouride mouth rinse immediately after purging (Mehler, 2011).
Sialadenosis - Sialadenosis or enlargement of the salivary glands (leading to dry mouth) can be treated through abstinence of vomiting, the application of heat and sucking of tart candies. In severe cases, Oral Pilocarpine may be prescribed to decompress the salivary glands. Pilocarpine is a parasympathetic muscarinic receptor agonist that increases secretion from the salivary glands and results in the decompression of the salivary glands. Symptoms associated with this medication include flushing, profuse sweating, bradycardia, and hypotension all of which may adversely affect an already poor body image (Mehler, 2011).
Tooth Sensitivity – Flourinated or descensitizing toothpastes
Sialadenosis - Sialadenosis or enlargement of the salivary glands (leading to dry mouth) can be treated through abstinence of vomiting, the application of heat and sucking of tart candies. In severe cases, Oral Pilocarpine may be prescribed to decompress the salivary glands. Pilocarpine is a parasympathetic muscarinic receptor agonist that increases secretion from the salivary glands and results in the decompression of the salivary glands. Symptoms associated with this medication include flushing, profuse sweating, bradycardia, and hypotension all of which may adversely affect an already poor body image (Mehler, 2011).
Tooth Sensitivity – Flourinated or descensitizing toothpastes
Treatment of Reflux Symptoms
According to Mehler (2011), proton pump inhibitors, histamine-2 receptor antagonists, and endoscopy oriented treatment are all treatment options.
Proton pump inhibitors are found to be most effective for healing esophagitis and improving symptoms (Mehler, 2011). Proton pumps also are proven to be safe on a long-term basis and more cost efficient than endoscopy-related treatment of reflux disease. The Proton-pump inhibitors work best if taken on an empty stomach followed by food ingestion 30 minutes later.
If Dysphagia, bleeding anemia, or persistent Dyspepsia are evident, an upper endoscopy is needed.
Metaclopramide may decrease the frequency of vomiting by acting on the central “emetic center” and increasing the muscle tone of the lower esophageal sphincter (Mehler, 2011).
Topiramate (Topamax), an antipileptic drug has been shown to reduce binging and purging episodes in patients suffering from bulimia. This drug has serious side effects; however, and should be used only if other medication has failed (Hall, Friedman & Leach, 2008).
Proton pump inhibitors are found to be most effective for healing esophagitis and improving symptoms (Mehler, 2011). Proton pumps also are proven to be safe on a long-term basis and more cost efficient than endoscopy-related treatment of reflux disease. The Proton-pump inhibitors work best if taken on an empty stomach followed by food ingestion 30 minutes later.
If Dysphagia, bleeding anemia, or persistent Dyspepsia are evident, an upper endoscopy is needed.
Metaclopramide may decrease the frequency of vomiting by acting on the central “emetic center” and increasing the muscle tone of the lower esophageal sphincter (Mehler, 2011).
Topiramate (Topamax), an antipileptic drug has been shown to reduce binging and purging episodes in patients suffering from bulimia. This drug has serious side effects; however, and should be used only if other medication has failed (Hall, Friedman & Leach, 2008).
Treatment of Laxative Abuse
Laxative dependence is difficult to treat but counseling is an important factor in the treatment. Other suggested conditions include ample hydration, a high-fiber diet, and a moderate exercise routine if a history of excessive exercise is not present (Mehler, 2011).
Pseudo-Bartter’s Syndrome or leg edema may be caused by abrupt cessation of laxatives and can be treated with salt restriction, elevation of legs, and patience. Spironolactone, an aldosterone antagonist may be given for 1-2 weeks after stopping laxative abuse (Mehler, 2011).
Pseudo-Bartter’s Syndrome or leg edema may be caused by abrupt cessation of laxatives and can be treated with salt restriction, elevation of legs, and patience. Spironolactone, an aldosterone antagonist may be given for 1-2 weeks after stopping laxative abuse (Mehler, 2011).
treatment of mallory-weiss syndrome
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According to a 2006 study, Endoscopic Band Litigation Surgery is an effective and safe procedure for treating the upper gastrointestinal bleeding related to Mallory-Weiss Syndrome which can result from a severe case of Bulimia Nervosa (Akahoshi, Higuchi, Kimura, Kubokawa, Motomura, Nawata &Sumida). Compared with other treatment methods (i.e. hemoclips placement and epinephrine injection) less recurrent bleeding has occured with the endoscopic band litigation surgery exluding a few cases where the surgery was not effective. (Antonietti, Ben-Soussan, Duclos, Ducrott, Lecliere, i, Iwanicki-Caron, & Ramirez, 2009).