The Relationship Between Bulimia, Acid Reflux & GERD

If left untreated, this digestive complication can eventually lead to gastroesophageal reflux disease (GERD) (also may be referred to as chronic acid reflux), a fairly serious, chronic condition that can also cause further health complications over time.

Can Bulimia Cause Acid Reflux?

Several studies have linked bulimia to gastroesophageal reflux disease, which is a severe, long-lasting condition caused by repeated gastroesophageal reflux (GER).¹

While it has been difficult to prove the link definitively, there is much anecdotal evidence connecting the ailments. Researchers believe the connection is strongest among people who experience purging-type bulimia nervosa, with repeated self-induced vomiting contributing to the conditions that cause acid reflux, GER, and GERD.

GER or GERD

Gastroesophageal reflux (GER) is a condition that occurs when a person unintentionally regurgitates the contents of their stomach back up into their esophagus.² This can cause a burning sensation up through the esophagus and heartburn. It can cause a person to vomit in some circumstances.

Repeated GER is a risk factor for developing GERD, or gastroesophageal reflux disease. This is often caused by the lower esophageal sphincter abnormally weakening or relaxing. Other symptoms associated with GERD include chest pain, nausea, difficulty swallowing, and complications of the mouth, throat, or lungs, including the development of a chronic cough or hoarseness.³ 

How Might Bulimia Contribute to Acid Reflux?

Bulimia is an eating disorder characterized by compensatory behaviors, such as purging, where individuals attempt to expel the contents of their stomach before food is fully digested. 

While this is done through several methods, a common form of purging is self-induced vomiting. The repeated exposure to stomach acid from this type of purging can cause damage to the esophagus, potentially affecting it in similar ways to those observed with GERD. 

It’s also important to note that, regardless of whether or not bulimia contributes to GERD, purging can cause numerous health complications. 

The act of self-inducing vomiting can tax the stomach and esophagus heavily, as muscles get strained and sensitive tissue is exposed to the hydrochloric acid normally contained in the stomach.

Long-Term Health Issues Related to Acid Reflux or GERD

GERD can potentially cause a condition called Barrett’s esophagus (BO), a condition in which the normal mucosal lining of the esophagus is replaced by a lining similar to that of the intestines.⁴ People who develop this condition are at risk of developing a rare and serious type of esophageal cancer (esophageal adenocarcinoma).

Additionally, GERD can cause strictures and ulcers to form in the esophagus as a result of the highly acidic contents of the stomach wearing away at tissue. These ulcers can be sensitive and may result in further health complications. If an ulcer ruptures or self-induced vomiting causes the esophagus to tear, the condition can be life-threatening.

Treatment for Esophageal Complications  

Acid reflux, GERD, and GER can be painful and uncomfortable conditions. Some over-the-counter medications may be used to help with mild acid reflux, but in cases where these conditions become chronic, more help may be needed.

Acid-suppressing medications called proton pump inhibitors (PPIs) are commonly prescribed to help with GERD and BO.⁵ This class of drugs can prevent further damage and allow damage that has already occurred to heal. 

Some people also require certain endoscopic therapies, which remove unhealthy tissue from the esophagus, thereby allowing room for new, healthier tissue to grow. And in severe cases, a type of surgery called an esophagectomy may be performed.

Ultimately, though, in cases where people struggle with bulimia, the best way to treat GERD, GER, or acid reflux is to treat the eating disorder itself. Prompt care can minimize potential health consequences and help someone avoid the need for multiple long-term treatments. 

Finding a Good Recovery Program

Bulimia and other eating disorders, such as binge eating disorder (BED) and anorexia nervosa, are complex mental health illnesses that do not go away on their own and can have very serious medical complications if left untreated for too long. If you suspect you or someone you love may have bulimia nervosa, it’s vital to seek help from a mental health professional who specializes in eating disorders as soon as possible. 

Treatment for bulimia is typically a multidisciplinary approach that involves some type of psychotherapy or talk therapy. Cognitive behavioral therapy (CBT) is the most widely known course of treatment. Other types of psychotherapy include:

• Acceptance and commitment therapy (ACT)
• Cognitive processing therapy (CPT)
• Dialectical behavior therapy (DBT)
• Emotionally focused therapy (EFT)
• Family therapy
• Internal family systems (IFS)
• Alternative therapies, such as art, dance, music, or yoga therapy 

In some instances, medications may also be prescribed to address conditions that commonly co-occur with bulimia and other eating disorders, such as depression or anxiety.

While recovery from bulimia doesn’t follow a linear path, and the journey can be long, it is possible.