Anorexia nervosa facts

Anorexia nervosa is an eating disorder and, more importantly, a psychological disorder. The cause of anorexia has not been definitively established, but self-esteem and bodyimage issues, societal pressures, and genetic factors likely each play a role. Anorexia affects females far more often than males and is most common in adolescent females. Anorexia tends to affect the middle and upper socioeconomic classes and Caucasians more often than less advantaged classes and ethnic minorities in the United States. The disorder affects about 1% of adolescent girls and about 0.3% of males in the U.S. People with anorexia tend to show compulsive behaviors, may become obsessed with food, and often show behaviors consistent with other addictions in their efforts to overly control their food intake and weight. Men with anorexia are more likely to also have other psychological problems; affected women tend to be more perfectionistic and be more displeased with their bodies. Children and adolescents with anorexia are at risk for a slowing of their growth and development. The extreme dieting and weight loss of anorexia can lead to a potentially fatal degree of malnutrition. Other possible complications of anorexia include heart-rhythm disturbances, digestive abnormalities, bone density loss, anemia, and hormonal and electrolyte imbalances. Given the prevalence of denial of symptoms by individuals with anorexia, gathering information from loved ones of the anorexia sufferer is important in the diagnosis and treatment of the disorder. Most medications are much better at treating symptoms that are associated with anorexia than addressing the specific symptoms of anorexia themselves. The treatment of anorexia must focus on more than just weight gain and often involves a combination of individual, group, and family psychotherapies in addition to nutritional counseling. The Maudsley model of family therapy, in which the family actively participates in helping their loved one achieve a more healthy weight, is considered the most effective method of family therapy for treating anorexia in adolescents. The prognosis of anorexia is variable, with some people making a full recovery. Others experience a fluctuating pattern of weight gain followed by relapse or a progressively deteriorating course over many years. Helping people understand the unrealistic and undesirable nature of media representations of excessive thinness as beautiful is one way to help prevent anorexia. As with many other illnesses with addictive symptoms, it takes a day-to-day effort to control the urge to relapse, and treatment may be needed on a long-term basis. Increased understanding of the causes and treatments for anorexia remain the focus of ongoing research in the effort to improve the outcomes of individuals with this disorder.

Introduction to nausea and vomiting

Nausea and vomiting are symptoms of an underlying illness and not a specific disease. Nausea is the sensation that the stomach wants to empty itself, while vomiting (emesis) or throwing up, is

the act of forcible emptying of the stomach. The term "dry heaves" refers to an episode of vomiting where there is no food in the stomach to vomit, and only clear secretions are vomited. Vomiting is a violent act in which the stomach almost turns itself inside out - forcing itself into the lower portion of the esophagus (the tube that connects the mouth to the stomach) during a vomiting episode, expelling food and secretions.

What causes nausea or vomiting?

There are numerous causes of nausea and vomiting. These symptoms may be due to the following:

Acute gastritis (direct irritation of the stomach lining) Central causes in which signals from the brain cause nausea and vomiting Other illnesses not due to stomach problems Medications and medical treatments Mechanical obstruction of the bowel

Acute gastritis and nausea and vomiting

Acute gastritis is often caused by an something that irritates the lining of the stomach. Examples of these circumstances include:

Infections: Infections are often the cause of stomach irritation, whether it is a common virus or another type of infection. There may be associated crampy upper abdominal pain that is associated with the nausea and vomiting. Fever ,and chills may be present. Common viral infections include noroviruses and rotavirus. Infection by bacteria in the Helicobacter family (such as H. Pylori) can also be the infectious agent. Stomach flu: Stomach flu (gastroenteritis) is when vomiting and diarrhea occur together that is associated with a viral infection. It should not be confused with influenza (symptoms include fever, chills, cough, and muscle pain. Food poisoning: Food poisoning may cause significant vomiting, and the most common cause is a toxin released by the bacteria Staphylococcus aureus. Symptoms of food poisoning begin within a couple hours of eating contaminated or poorly prepared food. Other bacterial causes of food poisoning include Salmonella, Campylobacter, Shigella, E. coli, Listeria, or Clostridium botulinum (botulism). Other stomach irritants: alcohol, smoking, and nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin and ibuprofen may irritate the stomach lining and cause nausea and vomiting. Peptic ulcer disease: Peptic ulcer disease can range from mild irritation of the stomach lining to the formation of a defect in the protective lining of the stomach called an ulcer. Gastroesophageal reflux disease (GERD, reflux esophagitis): Nausea or vomiting is also associated with GERD (acid from the stomach is refluxed into the esophagus).

Reviewed by Melissa Conrad Stppler, MD on 4/24/2012