Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Potential medical complications of bulimia nervosa to monitor include:
- Electrolyte imbalances such as hypokalaemia, which can lead to cardiac dysrhythmias and prolonged QT interval, especially in patients engaging in purging behaviors like vomiting, laxative or diuretic misuse NICE CKS,NICE NG69.
- Cardiac complications including bradycardia and arrhythmias; ECG monitoring is recommended for those with severe purging, significant weight changes, or on medications affecting cardiac function NICE CKS,NICE NG69.
- Dental erosion and oral health problems due to repeated vomiting; patients should be advised to avoid brushing teeth immediately after vomiting and to rinse with water or non-acidic mouthwash NICE CKS,NICE NG69.
- Gastrointestinal issues such as chronic laxative misuse leading to dependency and potential bowel dysfunction NICE CKS.
- Dehydration and malnutrition, which may cause muscular weakness and hypotension NICE CKS,NICE NG69.
- Risk of paracetamol toxicity due to low body weight and altered metabolism NICE CKS.
- Potential for severe electrolyte disturbances requiring acute medical care or inpatient admission if severe NICE NG69.
Regular monitoring in primary care should include weight/BMI, blood pressure, relevant blood tests including electrolytes, and ECG where indicated NICE CKS,NICE NG69. Coordination with specialist services is essential for managing these complications effectively NICE CKS.