Common medical problems associated with Chronic Anorexia

As a medical doctor treating almost exclusively people with eating disorders, I see a cross section of complex conditions in almost every medical field. This experience leads me to often have a very narrow band of knowledge to diagnose and treat unusual situations. This post will highlight some common medical problems with anorexia and the next post with bulimia. 

Anorexia frequently causes severe gastrointestinal issues. This system is essentially one long tube lined by muscles that moves food and then stool through the body. Like other muscles, disuse leads to atrophy. Anorexic patients experience a GI system that stops working, namely gastroparesis (slowed digestion) and colonic inertia (chronic constipation). The symptoms people experience are bloating, gas and often painful constipation, all of which makes it even more difficult to eat. Treatment has limited benefit and only eating truly heals the problem, a conundrum for someone with anorexia. 

Poor circulation is another common chronic problem, especially to the fingers and toes. It's not uncommon for people with anorexia to have blue or even white fingers and toes in the winter. Often it can take an hour to restore full circulation once someone comes inside from the cold. There are medications that improve these symptoms and stop worsening of the circulation. Malnutrition limits the body's ability to maintain distal circulation to parts of the body furthest from the heart and prioritizes the functioning of the most important organs. 

For many complex and not fully understood medical reasons, patients with anorexia have trouble managing fluids. What this means practically is that people can often get swelling in their legs and sometimes through their entire body. The body cannot manage where the excess fluid goes and so it can build up in various places, some of which are medically worrisome. At its worst, people can gain up to 20 lbs of fluid overnight only to lose it in a few days. The best way to manage this medical problem is to monitor symptoms carefully and not rush to any medical treatment. Typical treatment for swelling can be dangerous for someone with anorexia because the balance of health is precarious. It's best to let the body handle the fluid and just to watch the basic vital signs. 

These three medical effects of anorexia are relatively common although very different from healthy people of the same age. Knowing the best way to manage the symptoms is critical for someone sick with this illness to keep them safe. Following standard protocol may be dangerous because an anorexic body survives and functions very differently from a healthy one.