van Rijn C A
Psychiatrisch Ziekenhuis Endegeest, afd. Inwendige Geneeskunde, Oegstgeest.
Ned Tijdschr Geneeskd. 1998 Aug 15;142(33):1867-9.
Patients with anorexia nervosa or bulimia nervosa may try to compensate weight gain due to binge eating by purging: vomiting or use of diuretics, laxatives or diet pills. Purging may reduce the body weight through volume depletion, but has hardly any effect on the food uptake. Frequent vomiting is revealed by enlargement of the submandibular and parotid glands and rise of the serum amylase. Use of laxatives leads to electrolyte imbalances, lesions of intestinal mucosa and chronic obstipation. Physical effects of diuretics are dehydration and electrolyte imbalance; oedema may be a sign of their discontinuation. Frequent or major effects of purging are: disorders of cardiac conduction (caused by hypokalaemia), insults and cerebral dysfunction (both due to hyponatraemia). A normal serum potassium concentration does not exclude intracellular hypokalaemia; accordingly, electrocardiography is indicated.
呕吐或使用利尿剂、泻药或减肥药。催吐可能通过体液减少来减轻体重，但对食物摄取几乎没有影响。下颌下腺和腮腺肿大以及血清淀粉酶升高提示频繁呕吐。使用泻药会导致电解质失衡、肠黏膜损伤和慢性便秘。利尿剂的身体影响是脱水和电解质失衡；水肿可能是停用利尿剂的迹象。催吐的频繁或主要影响包括：心脏传导紊乱（由低钾血症引起）、损伤和脑功能障碍（均由低钠血症引起）。血清钾浓度正常并不排除细胞内低钾血症；因此，需要进行心电图检查。
