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Vomiting and feeling fat—Coincidence of achalasia and bulimia nervosa
Author(s) -
Teufel Martin,
Lamprecht Georg,
Zipfel Stephan,
Schrauth Markus,
Rapps Nora,
Martens Ute,
Gross Gaby
Publication year - 2009
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.20582
Subject(s) - vomiting , bulimia nervosa , achalasia , psychology , feeling , eating disorders , psychiatry , medicine , surgery , esophagus , social psychology
Objective: In clinical practice it is often difficult to distinguish between organic and psychological vomiting. Method: We present a case of a 34‐year‐old woman with an 18‐month history of vomiting with the initial diagnosis of bulimia nervosa (BN). However, the patient showed an unusual vomiting behavior. Therefore, further somatic diagnostic procedures were carried out leading to the additional diagnosis of achalasia. After successful interventional and surgical treatment for achalasia, further psychotherapeutic interventions were necessary because of worsening of the BN symptoms. A certain disturbed eating behavior seemed to persist at 3‐year follow‐up, while the medical condition had improved. Conclusion: It needs to be emphasized that careful diagnostic steps are indispensable to distinguish between psychological vomiting and organic vomiting. In case of two separate diseases a suitable treatment regime for each is required. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009