Do you know of any specialists who work with bulimics?

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My girlfriend was bulimic for several months. She used laxatives. It is now 2 or 3 years later and she is having stomach problems. She is lactose intolerant, which may complicate the matter. Last May she became severely constipated, which was extremely painful. After seeing a gastroenterologist for several months there was no solution to the problem. He prescribed several different “industrial strength” laxatives, which had no effect. Now, when things get bad she resorts to using regular laxatives (she’s done this once or twice). Although I am not concerned about her slipping back into bulimia (through counseling she’s past that stage), I do worry that this is going to be an on-going problem. Now for the question. Do you know of any specialists who work with bulimics, who she could see or contact?

Do you know of any solutions? It seems that this is a common problem, because 2 of her friends, also ex-bulimics, are in a similar, but not so serious situation. Any information that you can send me would be greatly appreciated.

Your girlfriend’s lactose intolerance and constipation problems may have nothing to do with a past history of bulimia. She can limit foods high in lactose and substitute lactase reduced milk (Lactaid) or switch to calcium and vitamin D enriched soy milk.

Constipation can result from too little fiber or water in her eating plan. High power laxatives are a short-term solution. I would suggest your girlfriend gradually increase the fiber content of her eating plan (a goal of 1 gram of fiber per 100 calories or 25 grams of fiber per day) by switching to 100% whole grains in bread, cereals, rice and pasta, cooked dried beans or peas, fresh fruits and fresh vegetables. This would be preferable to resort to laxatives again.

To determine if she is drinking enough water, suggest she look at the color of her urine. If a person is drinking enough water, urine should be light yellow and odorless during the waking hours of the day. An exception to this is vitamin C supplements will turn urine yellow as excess is excreted in urine.

Does she get constipated more often just prior to menstruation? Just prior to menstruation, there is a physiologic cause for constipation. Every month a woman’s body prepares for pregnancy and starts resorbing more fluid from the intestinal tract. This concentrates fecal material, makes it more hard and difficult to eliminate. I would suggest paying particular attention to increasing the fiber and fluid content of her eating plan during the week prior to menstruation.

Bulimia, anorexia and other eating disorders are best treated by psychologists. Suggest your girlfriend talk to her former therapist and ask that person to refer her to a gastroenterologist familiar with treating eating disorders.