1/7. iodine-induced hypothyroidism as a result of excessive intake of confectionery made with tangle weed, Kombu, used as a low calorie food during a bulimic period in a patient with anorexia nervosa.A 20-year-old Japanese female anorectic patient developed primary hypothyroidism associated with generalized edema because of excessive daily intake (40 to 50 g) of confectionery made with tangle weed, Kombu, which she substituted to food during bulimic periods; TSH 60.35 mcU/ml, free T3 1.19 pg/ml, and free T4 0.48 ng/dl, and her weight increased by 12 kg to 45 kg over 4 months. After withdrawal of Kombu her thyroid function returned to normal, and her weight decreased by 7 kg to 38 kg along with disappearance of edema. In conclusion, the physician noticed that susceptible anorectic patients may sometime develop hypothyroidism or hyperthyroidism because of excessive iodine intake of sea-weed confectionery as a substitute of high calorie cakes during bulimic period.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. pancreatitis causing death in bulimia nervosa.OBJECTIVE: We report the case of a 19-year-old woman with bulimia nervosa who died of acute hemorrhagic pancreatitis. Our objective is to raise awareness that because the symptoms of both conditions are very similar, the pre-existence of an eating disorder should not distract physicians from the possibility that potentially lethal acute pancreatitis may coexist. METHOD: The study includes autopsy results and a review of the literature. RESULTS: pancreatitis usually presents with abdominal pain, nausea, and vomiting. DISCUSSION: In patients with eating disorders who may already have exhibited these symptoms pancreatitis may not be considered. Elevated serum amylase values may occur in subjects with bulimia nervosa without pancreatitis. If the serum amylase value is elevated, pancreatitis can be confirmed by measuring the levels of serum lipase, trypsinogen, pancreatic isoenzyme of amylase, or by abdominal computerized tomography (CT).- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. An unusual cause of dizziness in bulimia nervosa: a case report.OBJECTIVE: The current article describes the case of a 23-year-old female with purging-type bulimia nervosa who was evaluated by her primary care physician for dizziness and lightheadedness. methods: After laboratory studies were performed by her primary care physician, the patient was admitted to the hospital because of severe anemia. The patient had been taking nonsteroidal antiinflammatory drugs (NSAIDS) at prescribed doses for shin splints that were secondary to jogging and developed gastric erosion. RESULTS: Endoscopic examination showed that she had diffuse gastritis with linear, streaky ulcerations throughout the body of the stomach. DISCUSSION: Lightheadedness is a common clinical symptom among individuals with eating disorders, but is typically related to dehydration, malnutrition, hypometabolism, and/or combinations of these factors. Clinicians need to consider NSAID use, which may cause erosive gastritis, blood loss, and lightheadedness.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
4/7. Prescription diuretic abuse in patients with bulimia nervosa.bulimia nervosa, a common eating disorder usually characterized by binge eating and self-induced vomiting, may also involve abuse of prescription diuretics. This article describes four patients who abused prescription diuretics in large quantities (up to 2 g/d of furosemide) for extended periods of time. physical examination and laboratory values provided few clues to the diagnosis of bulimia nervosa. Other eating-related behaviors previously linked to bulimia nervosa--including abuse of diet pills, illicit amphetamines, and laxatives, as well as withholding of insulin in one diabetic patient--were present in these cases. Usually the patients' primary physicians were not aware of these problems. physicians should be aware that patients requesting prescription diuretics may have bulimia nervosa.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Acute gastric necrosis in anorexia nervosa and bulimia. Two case reports.In recent years we have treated two patients with gastric infarction as a complication of anorexia nervosa and bulimia. We found only three other cases reported in the literature. Surgical intervention was delayed in all five patients either because the diagnosis was missed by the physician or because the patient failed to seek medical attention. physicians should be alerted to the possibility of acute gastric dilatation if a young woman, who may be undernourished and anorexic, complains of abdominal pain after ingestion of a large meal. Often this condition can be treated conservatively before irreversible damage to the gastric wall has taken place. If the gastric dilatation progresses, the stomach loses its contractility, resulting in venous occlusion, infarction, and gastric perforation. An extensive operation is required, and the patient undergoes an often complicated and prolonged hospital course.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Rumination syndrome.Rumination is a syndrome characterized by repetitive regurgitation of small amounts of food from the stomach. The food is then partially or completely rechewed, reswallowed, or expelled. This syndrome is relatively common in infants and mentally challenged persons, but it also occurs in adults with normal intelligence. The rumination syndrome is an underappreciated condition in adults who frequently receive a misdiagnosis of vomiting due to gastroparesis or gastroesophageal reflux. Difficulties in establishing the correct diagnosis may be caused by a lack of awareness of the condition among physicians. This syndrome must be considered in the differential diagnosis of a patient with regurgitation, vomiting (especially postprandial), and weight loss. Reassurance, explanations, and behavioral therapy are currently the mainstays of treatment in adults with normal intelligence who have the rumination syndrome. Appropriately controlled trials are needed to establish the best therapy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. diagnosis and treatment of bulimia nervosa.bulimia nervosa often has an obscure presentation that requires a high level of suspicion by physicians. awareness of subtle signs and knowledge of important questions to pursue are critical to a physician's ability to diagnose this disorder. Since bulimia nervosa may have several comorbid psychiatric disorders, such as depression, substance abuse, and personality disorders, it is important to refer patients for further evaluation and treatment. The treatment of bulimia nervosa is comprehensive and individualized and may include cognitive-behavioral therapy, group therapy, family therapy, individual psychotherapy, pharmacotherapy, or hospitalization. The comorbid disorders must also be addressed with appropriate treatment such as a drug or alcohol rehabilitation program for substance abusers. Although the prognosis can be variable, the majority of bulimic patients have a serious chronic illness with remissions and exacerbations.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |