Question

An 18-year-old female client has been losing weight for the past 2 months. The client feels she is fat and is a finicky eater. After she eats, she often goes to the bathroom and induces vomiting. Physical examination reveals the following findings: parotid gland enlarged, distended abdomen, and pain upon light palpation of the epigastric region and lower abdominal quadrants.

1. How would you relate these findings to the gastrointestinal system?

B. The act of vomiting would alter all digestion and absorption of foods. Explain.

Answer 1

The probable diagnosis of the patient is Anorexia nervosa.

A) The findings of GIT which are distended abdomen which is due to prolonged restriction of food causes atrophy of whole digestive system hence it causes gastroparesis and slow stomach emptying leads to bloating of stomach.

The enlargement of parotid is due to virgorous vomiting (bulimia nervosa) and nutritional deficiencies.

B)The act of vomiting would alter all digestion and absorption of food because the oesophageal valve would become flappy and allowing stomach HCl to flow into oesophagus and eroding its mucosa .

Other problem would be difficulty in swallowing due to lost muscle tone of oesophagus. Bloating , epigastric pain , altered pancreatic and liver enzymes would lead difficult digestion.