Bulimia - oesophageal varices?

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Phloston

Osaka, Japan
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I've read in a source that bulimia is associated with oesophageal varices. Could someone please explain why? It's probably simple and I'm just not getting it for some reason.

I could imagine bulimia being associated with Mallory-Weiss tears, but not varices. The only explanation I could think of is that the chronic vomiting somehow erodes the venous vasculature, but given that the veins wouldn't be distended (as they are with increased portal pressure), I don't really see that happening.

Any thoughts?

Cheers,

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because they eat too much, then they feel guilt and go to throw up, mechanical force from increased abdominal pressure causes mucosal tears

Edit:
Just looked at GI chapter in Goljan. Bulimia is discussed in context of Mallory-Weis, not esophageal varices.
 
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Having worked with on-off bulimics before school, few show any signs of tears in the esophagus or even acid "stains." Friends, family usually are the best hints, even though they
may be projecting their own problems.
It's hard to diagnose physically. Persistent electrolyte disorder is a fair indicator.
 
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