Review Article Biomedical Research and Clinical Practice Biomed Res Clin Prac, 2018 doi: 10.15761/BRCP.1000158 Volume 3(1): 1-5 ISSN: 2397-9631 Health consequences of bulimia nervosa Walter Milano, Luca Milano and Anna Capasso* Department of Pharmacy, University of Salerno, Salerno, Italy Abstract Bulimia Nervosa (BN) is coded for the presence of binge eating (binge eating) depression, characterized by the intake of a quantity of food that is signifcantly greater than that of most people (for example, two hours) would eat at the same time and in the same circumstances with a subjective feeling of loss of control over what you eat during the episode (for example, the feeling that you cannot stop eating or not being able to control what and how much you eat), followed by compensatory behaviors designed to minimize weight gain such as self-induced vomiting, misuse of laxatives and/or diuretics, fasting, intense physical activity, and clisters. BN can be difcult to identify because of the experience of secrecy and shame where the patient segregates binge crises and compensatory behaviors. Te weight may be normal or slightly higher than normal. Often, in history, there is a history of AN or restrictive diet Te health consequences of BN are extremely variable and can occur with only modest biological and physical damage up to extremely serious and life-threatening conditions; the mortality rate of young subjects. Te management of the medical-internship aspects of BN is rightly placed within complex and articulated programs of interdisciplinary treatment with diferent levels of intensity of care (outpatient, semi-residential/residential, hospital in cases of emergency/medical and/or psychiatric emergency). Tis review focuses on health consequences associated with bulimia nervosa. *Correspondence to: Anna Capasso, Department of Pharmacy, University of Salerno, Salerno, Italy, Tel: (304) 293-5110; E-mail: annacap@unisa.it Key words: bulimia nervosa, eating disorders, health consequences, psychiatric emergency Received: February 11, 2018; Accepted: February 23, 2018; Published: February 27, 2018 Introduction Bulimia nervosa (BN) defnes clinical patterns characterized by aberrations of eating behavior, with potentially serious clinical repercussions. Te bulimic patient alternates between restrictive periods and periods with hyperphagic access followed by vomiting; abuse of laxatives, diuretics and slimming drugs; often an exhausting physical activity is the first symptom of an excessive desire for weight reduction [1-3]. Te BN is characterized by a wide spectrum of clinical presentations: from the mildest form that can be spontaneously reversed, to the severe forms that undergo progressive deterioration. In over a third of cases, difculties in social and family adaptation persist despite clinical recovery [1-3]. Hospitalization becomes necessary when the patient has severe bulimic episodes, depressive crises with suicidal intent or important metabolic imbalances. In addition to suicides, general mortality is linked to the complications of malnutrition, including infectious episodes, cardiovascular collapse, electrolyte imbalances and fnally cardiac arrhythmias [1-3]. Early expression of bulimia nervosa is the damage of the digestive system, from the oral cavity to the intestine. Te symptomatology is quite variable and is ofen hidden to the doctor: it becomes therefore an unavoidable task of the doctors involved in the diagnosis and coordinated care of the bulimia nervosa to decode as soon as possible the most strictly clinical symptoms. It is important to remember that the bulimic patient is usually normal or overweight [4,5]. Dental complications Bulimia nervosa can lead to a series of odontostomatological manifestations (which may involve hard tissues, sof tissues and salivary glands) classifed in primary and secondary. Among the primaries we remember dental erosions up to exposure of the pulp, loss of substance or fracture of teeth, increased incidence of caries, dentinal hypersensitivity, xerostomia, periodontal diseases, glossodynia, cheilitis. Among the secondary ones there is the hypertrophy of the salivary glands, especially of the parotid, the occlusal anomalies, the impairment of the masticatory capacity, the aesthetic alterations [6]. Dental erosions are related to self-induced vomiting and gastroesophageal refux, due to the acidity of gastric juice [6]. Te carious pathology seems to be due to a decrease in salivary pH typical of post-vomiting, with consequent bacterial proliferation and abatement of the bufering power of saliva, as well as the type of diet, rich in carbohydrates and sugary foods (candies, chocolate, etc.) [7]. In many cases we can observe a parotid hypertrophy, related to malnutrition, chronic glandular stimulation refected by excessive carbohydrate intake, buccal mucosal irritation by self-induction of vomiting or alcohol abuse [8]. It can be said that all the dental complications stated are related to vomiting, to the reduction of salivary fow, to gastroesophageal refux and can be progressive and serious. Since they already occur early in the disease, clinicians who take care of ED should be urged to also include the dentist in the staf, in order to monitor, prevent and treat the injuries present.