The Relationship Between Bulimia, Acid Reflux & GERD

While research is ongoing, there have been some studies and reports suggesting a relationship between bulimia nervosa (BN) and acid reflux.

If left untreated, this type of digestive difficulty can eventually lead to gastroesophageal reflux disease (GERD), a fairly serious, chronic condition that can also cause further health complications over time.

Bulimia and acid reflux

A review of available literature found several studies that linked bulimia nervosa 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.


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 potentially cause a person to vomit in some circumstances.

Gastroesophageal reflux disease (GERD) can develop from repeated GER, 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] 

GERD sometimes results in serious health complications. You should see a doctor if you experience any of the following symptoms:

  • Chest pain
  • Loss of appetite
  • Persistent vomiting
  • Difficulty swallowing or pain while swallowing
  • Bleeding of the digestive tract, including seeing blood in stool or vomit
  • Unexplained weight loss

How Might Bulimia Contribute to Acid Reflux?

Some forms of bulimia involve purging, where a patient tries to expel the contents of their stomach before food can be fully digested. 

While this is done through several methods, a common form of purging is self-induced vomiting. And 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 esophageal adenocarcinoma, a rare and serious type of cancer.

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 they can 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.

Proton Pump Inhibitors

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


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

Eating Disorder Treatment

Ultimately, though, in cases where people struggle with BN, 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 having to potentially undergo multiple long-term treatments at once. 

Finding a Good Recovery Program

If you are struggling with bulimia nervosa and want to start your journey toward recovery, comprehensive treatment is the best way to get there. 

Most often, treatment for BN will involve some type of psychotherapy or talk therapy. Cognitive behavioral therapy (CBT) is the most widely-recommended course of treatment for people with bulimia nervosa, though dialectical behavior therapy (DBT), family therapy, art therapy, or other modalities may serve you better, depending on individual circumstances.

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.

A good resource for people struggling with eating disorders is the National Eating Disorders Association (NEDA) Helpline, which you can call at (800) 931-2237 or text at (800) 931-2237. This free service will allow you to talk to trained volunteers and get some introductory advice and more information about where you can get more structured expert help. For individuals who are overwhelmed and don’t know where to begin, these people can help guide you in the right direction.

You can also explore our site and see what kind of help our experts may be able to provide. 

While recovery from bulimia doesn’t always follow a linear path and the journey can be long, finding the right kind of help can help you can effectively treat your eating disorder and live a happy life in sustained recovery.


  1. Denholm, M., Jankowski, J. (2011, February 1). Gastroesophageal Reflux Disease and Bulimia Nervosa – A Review of the Literature. Diseases of the Esophagus, 24(2):79-85.
  2. Acid Reflux (GER & GERD) in Adults. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved September 17, 2022.
  3. Symptoms & Causes of GER & GERD. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved September 17, 2022.
  4. Barrett’s Esophagus. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved September 17, 2022.
  5. Treatment for Barrett’s Esophagus. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved September 17, 2022. 
  6. Contact the Helpline. National Eating Disorders Association. Retrieved September 17, 2022.

Last Update | 01 - 3 - 2023

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