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307.51 Bulimia Nervosa - Associated physical examination findings and general medical conditions

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Recurrent vomiting eventually leads to a significant and permanent loss of dental enamel, especially from lingual surfaces of the front teeth. These teeth may become chipped and appear ragged and "moth-eaten." There may also be an increased frequency of dental cavities. In some individuals, the salivary glands, particularly the parotid glands, may become notably enlarged. Individuals who induce vomiting by manually stimulating the gag reflex may develop calluses or scars on the dorsal surface of the hand from repeated trauma from the teeth. Serious cardiac and skeletal myopathies have been reported among individuals who regularly use syrup of ipecac to induce vomiting.

Menstrual irregularity or amenorrhea sometimes occurs among females with Bulimia Nervosa; whether such disturbances are related to weight fluctuations, to nutritional deficiencies, or to emotional stress is uncertain. Individuals who chronically abuse laxatives may become dependent on their use to stimulate bowel movements. The fluid and electrolyte disturbances resulting from the purging behavior are sometimes sufficiently severe to constitute medically serious problems. Rare but potentially fatal complications include esophageal tears, gastric rupture, and cardiac arrhythmias. Compared with individuals with Bulimia Nervosa, Nonpurging Type, those with the Purging Type are much more likely to have physical problems such as fluid and electrolyte disturbances.

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JoannaPoppink The staggering loss of the Arctic Ocean’s oldest sea ice shown in time-lapse https://t.co/G4qr5DHEsS
5mreplyretweetfavorite
5mreplyretweetfavorite
JoannaPoppink Trail cameras capture new images of Oregon’s only wolves in northern Cascades https://t.co/etGvGiYPQn
12hreplyretweetfavorite
12hreplyretweetfavorite
JoannaPoppink Oxford Dictionaries declares 'climate emergency' the word of 2019 https://t.co/kSu1VIvikj by @naamanzhou

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