A person with bulimia nervosa may regularly induce vomiting after eating. Doctors refer to this practice as purging. Purging behavior in bulimia may increase a person’s risk of esophageal cancer.

Exposing the esophagus to stomach acid when purging can irritate the mucosal lining. The damage can then result in symptoms such as difficulty swallowing, indigestion, and loss of appetite.

Read on to find out why bulimia may increase the risk of esophageal cancer, how to heal the esophagus, and more.

A person has their hands on their throat.Share on Pinterest
miniseries/Getty Images

Bulimia may increase the risk of esophageal cancer. According to a 2019 review published in Nutrients, self-induced vomiting may damage the esophagus with acid in a similar way to gastroesophageal reflux disease (GERD), increasing the risk of developing cancer.

However, researchers have also identified a number of other factors that could affect a person’s esophageal cancer risk, including:

  • hormonal changes
  • sexual activity
  • nutritional status
  • excessive tobacco or alcohol use

Self-induced vomiting may be linked to a condition called Barrett’s esophagus. This can occur if the esophagus has repeated exposure to acid. Learn more about Barrett’s esophagus.

In a person with Barrett’s esophagus, gastrointestinal columnar cells replace the squamous cells lining the esophagus. This leads to a 30-fold increase in the risk of developing esophageal cancer.

To induce vomiting after eating, a person may stimulate the larynx at the back of the throat. This causes the abdominal walls to contract and force out the stomach contents.

Doing this exposes the esophagus and mouth to stomach acid, disturbing the regular environment of these parts of the digestive tract. Repeated vomiting can lead to dehydration and loss of salts and minerals known as electrolytes, including potassium and sodium.

It also irritates and potentially damages the lining of the digestive tract.

Damage to the esophagus may develop over time at different rates for each person. A 2016 review reported no association between the gastrointestinal symptoms associated with bulimia nervosa and the duration or severity of the purging behavior.

The researchers said that the extent of damage to the esophagus could depend on the individual’s sensitivity to esophageal damage rather than to how often they induce vomiting.

Esophageal cancer does not usually cause symptoms at first. However, it may cause difficulty swallowing and other problems as the tumor grows.

Difficulty swallowing is the most common symptom. Other symptoms a person may develop include:

In rare cases, a person may vomit or cough up blood.

Learn more about the symptoms of esophageal cancer.

Stopping self-induced vomiting is a primary goal of treatment for bulimia because vomiting carries numerous health consequences. A doctor may recommend treatments such as cognitive behavioral therapy for a person with bulimia.

Doctors may also recommend proton pump inhibitors, which reduce the amount of stomach acid a person produces. The GERD medication metoclopramide may also help by speeding up stomach emptying and increasing tone in the lower esophageal sphincter.

If a person’s symptoms last a long time or do not respond to treatment, doctors may recommend an endoscopy. This procedure can help doctors detect precancerous changes in the esophageal lining that occur in Barrett’s esophagus.

In rare cases, people can rupture their esophagus, which is known as Boerhaave syndrome, and experience Mallory-Weiss tears. These occur when repeated vomiting causes damage to the upper part of the gastrointestinal tract. Surgery may be necessary.

Bulimia can affect a person’s physical and mental health and quality of life. It is important to seek medical help if a person notices symptoms of bulimia nervosa in themselves or someone else. A doctor may then refer a person to other support services, such as a psychotherapist.

A person should also contact their doctor if they are experiencing any symptoms of esophageal cancer, such as:

  • trouble swallowing
  • heartburn on most days for 3 weeks or longer
  • any other symptoms that are unusual or do not go away

In many cases, cancer will not be the cause of these symptoms. However, it is important to consult a doctor so that they can rule out cancer and help the person access the treatment they need.

Repeated self-induced vomiting in a person with bulimia can cause acidic damage to the esophagus, which may increase the risk of esophageal cancer.

The most common symptom of esophageal cancer is difficulty swallowing. A person may also experience symptoms such as heartburn, loss of appetite, and hoarseness.

Research suggests that the time it takes for bulimia to damage the esophagus depends on the individual’s sensitivity to esophageal damage rather than how long they have been making themselves vomit.

Stopping vomiting is the primary means of healing the esophagus, but sometimes doctors may recommend medication or endoscopy.

A person should contact a doctor if they have concerns about bulimia or esophageal cancer.