How to Conduct a Physical Exam to Detect Bulimia

A comprehensive physical exam is important not only to diagnose bulimia, but to see what treatments will be needed to correct often extensive bodily damage. There are a few tests you need to be sure to do when you conduct a physical exam to detect bulimia.

Instructions

Difficulty: Challenging

Things You’ll Need:

• Medical expertise and training

Conduct a Physical Exam to Detect Bulimia

1. Look at the tooth enamel, especially on the rear faces of the front teeth. Stomach acids from habitual vomiting can cause damage to the teeth and also make the glands in the mouth look inflamed. Check the back of the patient's hand for calluses or scars as a result of the teeth clamping down on it while he forces a gag reflex.
2. Take a blood sample from the patient and check the red blood cell and white blood cell levels. Bulimia can even cause low levels of platelet cells. Look at the patient's iron stores to see if she will need to take iron supplements.
3. Listen to the patient's heartbeat with a stethoscope to check for an irregular heartbeat. If one is present, then also conduct blood work to look for low potassium levels. In some cases, the patient may require immediate intravenous potassium supplements to prevent heart failure.
4. Weigh the patient and compare his weight against the average for a person of his age, height and build. Bulimic patients can be as much as 15 percent lower than the expected weight for their medical group.
5. Use a urinalysis to screen for kidney and thyroid damage as a result of malnutrition. Refer the patient to a lab if you do not have the proper equipment for these tests. Prescribe or recommend vitamin supplements and dietary needs based on the results of these tests.
6. Talk to female patients about any abnormal menstrual changes. While not a common syndrome of bulimia, irregular menstruation can result from anorexic behavior following bulimic purging.
7. Schedule a follow-up visit with the patient to reexamine his condition in 1 to 2 weeks. Talk to the parents or roommates of the patient about establishing a weight tracking program to detect futures episodes of bulimia.

Tips & Warnings

• Any tooth damage you detect will need to be corrected by the patient's dentist before it worsens.
• You may want to tell the patient to avoid diuretics for several weeks and drink at least eight glasses of water each day if blood tests show signs of dehydration.