Bulimia & GERD: Causes, Signs & Treatment 

Bulimia nervosa (BN) can cause or aggravate a variety of gastrointestinal problems, including gastroesophageal reflux disease (GERD). 

The stomach condition is most closely tied to purging type bulimia nervosa, which is expressed when someone physically purges the contents of their stomach, through any variety of methods.

Stomach issues

Self-induced vomiting is one of the most common methods used by people with purging type BN and also the behavior most closely associated with GERD.

What Is GERD?

Gastroesophageal reflux disease (GERD) is a chronic condition when stomach acid or bile consistently flows back into the esophagus, the tube that connects the mouth and stomach. This most commonly happens when the lower esophageal sphincter—the muscle that opens and closes to allow food and stomach acid through—is damaged or does not work properly. 

Generally, the damage or dysfunction will cause the lower esophageal sphincter to relax when it is not supposed to or weaken the muscle, rendering it less effective. 

Signs and symptoms of GERD can include: [1]

  • Heartburn
  • Regurgitation (when stomach contents come back up the esophagus and throat and/or mouth, which can cause a sour taste in the mouth)
  • Nausea
  • Chest pain
  • Chronic cough
  • Hoarseness
  • Pain while swallowing
  • Swallowing difficulties
  • Signs of bleeding in the digestive tract
  • Loss of appetite
  • Persistent vomiting

How Can Bulimia Cause or Exacerbate GERD?

The biggest connection between bulimia nervosa and GERD is the purging behavior of self-induced vomiting.

Repeatedly putting stress on the esophageal sphincter to work in reverse can cause much of the damage and weakness associated with GERD. Exposing the muscle to regurgitated stomach acid can cause further damage. [2] 

If someone is already struggling with GERD, self-induced vomiting can aggravate the condition, leading to more severe symptoms.

But the binging and purging cycles involved in every type of bulimia nervosa can also exacerbate GERD. These eating habits tend to cause an expansion of the stomach, which can lead to gastrointestinal (GI) problems, including reflux. [3] 

Patient at doctor's office

Can GERD Lead to Long-Term Health Issues?

While GERD is often uncomfortable and associated with a number of physical symptoms, the condition can create more serious health complications when experienced on a long-term basis. 

Some of these conditions include: [4]

  • Esophagitis: Irritation and inflammation in the lining of the esophagus. This can also trigger ulcers in the esophagus.
  • Strictures: The scarring and narrowing of the lining of the esophagus caused by damage from exposure to stomach acid. This can make swallowing food and eating and drinking normally even more difficult.
  • Barrett’s esophagus: Persistent acid reflux over a period of years can change the cells in the esophagus lining. This can cause them to thicken and turn red. This is a risk factor and precursor to cancer in the esophagus.
  • Esophageal cancer: Adenocarcinoma is a type of cancer of the lower esophagus that can develop from Barrett’s esophagus. GERD can also be a risk factor for developing squamous cell carcinoma in the cells lining the upper and middle part of the esophagus.

GERD can also contribute to additional eating issues, malnutrition, and unhealthy weight loss, which can cause a variety of additional health concerns that can even become life-threatening. 

Seeking Help for Bulimia Nervosa

Bulimia is a serious eating disorder with significant health complications. The sooner you can get help for yourself or a loved one, the better. 

If you find that you or your loved one worry excessively about weight, body shape, and size, and take action to “undo” the effects of eating, including through overexercise, self-induced vomiting, or abusing laxatives, it may be time to seek professional help.

Therapy and Counseling

Treatment for bulimia involves nutritional and psychological counseling. In therapy, you’ll work through triggers and biological, cultural, interpersonal, social, and internal factors involved in the condition. 

Nutritional Counseling

Professional help for bulimia can involve medical and mental health personnel as well as nutritional counselors. The treatment plan will depend on each individual’s needs and circumstances. Early intervention and treatment are ideal for a healthy, sustained recovery.

The most important thing to remember is that help is always possible. Seeking treatment for bulimia nervosa may not be easy, but it can help you or a loved one find a path toward a healthier and happier future.


  1. Symptoms & Causes of GER & GERD. 2020, July. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved September 20, 2022.
  2. Denholm, M., & Jankowski, J. (2011). Gastroesophageal reflux disease and bulimia nervosa–a review of the literature. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus; 24(2): 79–85.
  3. Peat, C. M., Huang, L., Thornton, L. M., Von Holle, A. F., Trace, S. E., Lichtenstein, P., Pedersen, N. L., Overby, D. W., & Bulik, C. M. (2013). Binge eating, body mass index, and gastrointestinal symptoms. Journal of psychosomatic research; 75(5): 456–461.
  4. GERD (Chronic Acid Reflux). (2019, December 6). Cleveland Clinic. Retrieved September 20, 2022.

Last Update | 01 - 9 - 2023

Medical Disclaimer

Any information provided on the bulimia.com is for educational purposes only. The information on this site should not substitute for professional medical advice. Please consult with a medical professional if you are seeking medical advice, a diagnosis or any treatment solutions. Bulimia.com is not liable for any issues associated with acting upon any information on this site.