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May 16, 2008

Behavior, Complications

Question from Melvindale, Michigan, USA:

I've recently started purging a little bit of some of my meals. My reasons for purging aren't so much to try and lose weight as I know that it doesn't work that way. It is because after eating a lot of the time, I can physically feel the food sitting in my stomach and it gets really uncomfortable and it seems as though it's the only way to get any relief. This can and will happen no matter how much or how little I've eaten. I guess a part of me is wondering if it might be gastroparesis as I've had a lot of abdominal trauma over the last couple of years, starting with peptic ulcers, then a bowel resection and, most recently, a really large hernia repair (post operative from the resection). All of this came after I had gastric bypass in October 2003. Is there any specific test to diagnose that particular complication? My other question is (aside from the obvious, low and or out of control blood sugar), is it any more dangerous for a type 1 diabetic to engage in such behaviors as opposed to a non-diabetic?

Answer:

First, there are multiple medical issues that need to be addressed so it is important you speak with your physician about these. The gastric bypass could surely put you at risk for ulcers that give you a discomfort after eating. Second, it is possible that you could have decreased emptying of your stomach. Your natural anatomy and function have been changed by the procedure. It may be necessary to scope the upper gastrointestinal tract or to look at an upper gastrointestinal study with contrast swallowed by mouth to look for any obvious problems. If there are none, I think you have to look for some relief by some other means besides purging. This is damaging to your teeth, your upper gastrointestinal tract, and is a slippery slope to an established eating disorder. Individuals with type 1 diabetes who develop an eating disorder have much poorer outcomes with their diabetes. They have a much higher risk of complications with their diabetes. It seems to me that the purging is only a stopgap measure and that you need to have a heart-to-heart with your physician soon.

JTL