Patients who purge by vomiting may present with metabolic alkalosis (elevated serum bicarbonate levels) due to volume contraction. However, patients who primarily abuse laxatives may present with metabolic acidosis (decreased serum bicarbonate levels) due to loss of alkaline fluid from the bowel.
Can anorexia cause metabolic acidosis?
The onset of a metabolic acidosis in a patient with anorexia nervosa remains very rare, but also exceptionally severe and unknown to physicians. To our knowledge, this is the first reported case of starvation-induced metabolic acidosis in a non-diabetic adolescent with anorexia nervosa.
Does anorexia nervosa cause electrolyte imbalances?
The most frequent electrolyte imbalances seen in anorexia are hyponatremia (a low concentration of sodium ions in the bloodstream) and hypokalemia (a low concentration of potassium ions).
How does anorexia nervosa cause hypokalemia?
Inpatients with anorexia nervosa presumably have a higher risk of developing hypokalemia because they suffer from severe malnutrition and are refed [21], in which the insulin surge resulting from glycemia during the refeeding process causes a substantial intracellular uptake of potassium and phosphorus [20].
Why does anorexia cause metabolic alkalosis?
In anorexia nervosa, under-nutrition and weight regulatory behaviours such as vomiting and laxative abuse can lead to a range of biochemical problems. Hypokalaemia is the most common electrolyte abnormality. Metabolic alkalosis occurs in patients who vomit or abuse diuretics and acidosis in those misusing laxatives.
Why is bicarbonate high in metabolic alkalosis?
In metabolic alkalosis there is excess of bicarbonate in the body fluids. It can occur in a variety of conditions. It may be due to digestive issues, like repeated vomiting, that disrupt the blood’s acid-base balance. It can also be due to complications of conditions affecting the heart, liver and kidneys.
What is the hallmark of anorexia nervosa?
What are the hallmarks of anorexia nervosa? The core psychological feature of anorexia nervosa is the extreme overvaluation of shape and weight. People with anorexia also have the physical capacity to tolerate extreme self imposed weight loss. Food restriction is only one aspect of the practices used to lose weight.
Can anorexia cause lactic acidosis?
The etiology of lactic acidosis in the reported case is probably multifactorial including hypotension, volume depletion, hypothermia, (all due to anorexia nervosa with the subsequent impairment in renal and hepatic function) and probably metformin overdose. The mortality inreported cases is about 50 percent.
Why does anorexia cause dehydration?
Dehydration and Anorexia This is because solid foods also contain water that our bodies can absorb. Therefore, if your child is severely restricting their food intake, they may have a lower fluid intake. This can lead to dehydration.
Why does anorexia cause hyponatremia?
Background: Anorexia nervosa may be revealed by hyponatremia or associated with it. This hyponatremia can be due to diuretics or laxatives abuse, potomania or inappropriate secretion of antidiuretic hormone as in the case reported here.
Which eating disorder is most closely associated with electrolyte imbalances?
Re-feeding syndrome is one of the most dangerous and well-known complications from anorexia nervosa. Although the disorder itself does not result in increased mortality, the electrolyte disturbances that occur secondary to this disorder result in cardiac and renal failure potentially causing death.
How does anorexia cause hyponatremia?
Hyponatremia can also be seen in severe restrictive eating disorders due to decreased ability of the kidney to excrete free water as a result of low nutritional intake. Without enough food or solutes, even a fairly normal amount of water intake can lead to hyponatremia if the body retains too much of it.
What happens to potassium in anorexia?
When calories are reintroduced to a starving body, potassium and other key electrolytes are absorbed into the new tissue cells, lowering the concentration of electrolytes in the blood. Cardiac complications of hypokalemia can include an irregular heartbeat, low blood pressure and cardiac arrest.
Is hyperkalemia associated with anorexia nervosa?
In an adolescent with anorexia nervosa, recurrent hyperkalemia was caused by obsessive eating of up to 20 bananas per day. In another case, a patient with schizophrenia and psychogenic polydipsia was water-restricted but developed hyperkalemia because she replaced water with excessive consumption of orange juice.
Can malnutrition cause low potassium?
Mortality rates increase if potassium levels are below 2.5 mEq/l (severe hypokalaemia) [4]. Poor intake and poor muscle bulk in malnourished children results in the fall of total serum potassium levels (by as much as 25%).
What is refeeding syndrome in anorexia?
Refeeding syndrome (RS) is one of the serious complications during treatment of anorexia nervosa. It includes hormonal and metabolic changes that occur during the process of refeeding in chronically malnourished patient when nutrition is introduced in an excessive and improper amount.
What other disorders might occur with anorexia nervosa?
- Anxiety.
- Depression.
- Substance abuse/alcohol.
- Self-injury.
- Borderline personality disorder (BPD)
- Obsessive-compulsive disorder (OCD)
Can metabolic alkalosis cause seizures?
Complications. Alkalosis may lead to tetany, seizures, and decreased mental status. Metabolic alkalosis also decreases coronary blood flow and predisposes persons to refractory arrhythmias.
Can dehydration cause metabolic alkalosis?
Hypochloremic alkalosis is a serious condition that can put you into shock. It can result from dehydration and other causes.
What are the signs and symptoms of metabolic alkalosis?
- Confusion (can progress to stupor or coma)
- Hand tremor.
- Lightheadedness.
- Muscle twitching.
- Nausea, vomiting.
- Numbness or tingling in the face, hands, or feet.
- Prolonged muscle spasms (tetany)
How do you reverse metabolic alkalosis?
Doctors rarely simply give acid, such as hydrochloric acid, to reverse the alkalosis. Metabolic alkalosis is usually treated by replacing water and electrolytes (sodium and potassium) while treating the cause. Rarely, when metabolic alkalosis is very severe, dilute acid is given intravenously.
What are 4 characteristics of anorexia nervosa?
Anorexia nervosa is characterized by emaciation, a relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight, a distortion of body image and intense fear of gaining weight, a lack of menstruation among girls and women, and extremely disturbed eating behavior.
What happens to the body in anorexia nervosa?
Untreated, anorexia nervosa can lead to: Damaged organs, especially the heart, brain, and kidneys. Drop in blood pressure, pulse, and breathing rates. Loss of hair.
Who was the first person diagnosed with anorexia?
1613: Jane Balan – the “French fasting girl of Confolens” He noted that she “lived without receiving meat or drink for at least three years.” The condition began on 15 February 1599, when Jane Balans was around 10 years old. After suffering a fever and vomiting, she became withdrawn and weakened, refusing all food.
Do anorexics get ketoacidosis?
We here report a case of diabetic ketoacidosis at onset of type 1 diabetes after a prolonged period of starvation due to anorexia nervosa.