A Basic Physiology Lesson
The two main electrolytes (or ions) that people with EDs need to concern themselves with
are potassium (K+) and sodium (Na+). Water is also extremely important, although it is not
an ion, it is affected by shifts in sodium balance
Electrolytes do a number of essential functions within the body; they assist in regulating
fluid balance, participate in acid-base homeostasis, contribute to enzyme reactions and play
an invaluable role in neuromuscular activity. I won't use the technical jargon too much, because I want to make this information as accessible as possible.
With respect to laxatives...there are a number of different types ...the worst being the
stimulants like EX-LAX or CORRECTAAL. These
pill/chocolate concoctions simply stimulate the nerve endings in the large intestine to react
to an artificially induced muscle contraction ... that's all. It doesn't do anything but cause
the large intestine to excrete what it absorbs -- which is WATER and other necessary
electrolytes. It's the SMALL intestine which absorbs, digests and distributes food products
-- the large intestine is in charge of water and ions. In the early stages of laxative abuse, a person might lose what they think is weight, when it is only water and K+
(among other trace elements) that they're losing. In fact, the food has already been absorbed by the small intestine by the time the laxative takes effect. Gradually, the user requires larger doses to maintain the same type of reaction from their system, because the body adapts to this new "induced-excretion". When someone uses laxatives in large quantities OR for a prolonged period of time . . . the body adjusts to the abuse and the stimulation of the large bowel, and it relies on the pills rather than its own natural ability to rid the body of wastes; by this time, it's usually not waste product that's being excreted, either -- it's essential ions which contribute to a number of important functions to the entire body. Symptoms include dehydration, bloating (severe in many cases), fatigue,
muscle cramps and/or weakness, lack of coordination and general moodiness (try not having a bowel movement for a week and tell me you feel like smiling . . . !)
Using laxatives will cause permanent damage to the large intestine. Many abusers underestimate this fact because the physical signs of bowel dysfunction may not occur instantly, but it will occur -- and once it does, the experience can be extremely annoying,
embarrassing and painful. The average person can and should excrete fecal matter, approximately once a day, if not more. Laxative abusers may experience weeks without
having a single episode. If the colon has to compress a week's worth of waste products into one "package", then you can imagine how the process of excretion can rip and tear the rectal tissues from the inside, on its way out . . . causing extreme pain, bleeding and oftentimes, shame. I'm being brazen with my descriptions, I know . . . I intentionally mean to offend, because it IS an offensive thing we do to our bodies and I think it should be described as it is.
Emetic Abuse & Manual Stimulation of the Gag Reflex
Emetics are artificial stimulants which induce vomiting, such as the brand-name product
"syrup of Ipecac". Emetics are generally used in emergency situations to evacuate poisonous toxins
from the body (which may have been ingested accidently or otherwise). The abuse of
emetics and/or the manual stimulation of the gag reflex, cause multiple physiological
The body is a very smart and efficient organism. Just when you think you've got it
"fooled," and you've retained control of your body, it will retaliate with a vengeance in a
furious attempt to save you from yourself.
Just as with laxatives, approximately 2/3 of any food ingested has already been absorbed
and begun digestion by the small intestine by the time a person throws up. A person may
toss up a lot of physical evidence, but the nutritional value of the food may already be
absorbed by the body before the act of vomiting has occurred. As the body fights the act of
purging, it struggles to keep down whatever food it is given and digests whatever nutrients
it can get. Hence, a seasoned vomiter may have the purging action down to a science, but
the body will have adapted to this behaviour by speeding up the early stages of digestion --
faster than people who do not throw up. Digestion starts with the saliva and ends in the
rectum and the body recruits all of its forces to fight the "enemy" which deprives it of its
nourishment, so it speeds up the pre-digestion, salivary response, peptic acid response and
jejunal (small intestine) digestion process so that it has something of nutritional value to
retain once the person starts her purging routine.
Eventually, with throwing up . . . the acids in the stomach (which can eat through the outer
shell of a '76 Buick) wear down the enamel of the teeth, cause ulcers and perforations
anywhere from the stomach through to the mouth (oesophagus, trachea, etc.) and wear
down the heart muscle from the extreme trauma of intense muscle contraction which
results from gagging. The heart suffers with prolonged vomiting. Electrolyte imbalance
causes dysrhythmia (alterations in heart rate, stroke volume and beat irregularities),
muscle weakness (without the proper ions present, the muscle simply won't function, and
the heart is a muscle just as any other) and PAIN (try breathing deeply with a perforated
oesophagus . . . ouch!!).
Lastly...I'll briefly describe Na+ and K+ and their importance to the body, with a few
practical tips on how to help yourself maintain electrolyte balance the best you can, if you
have an ED.
Sodium and water go hand in hand. When one fluctuates, the other is affected in reciprocal
fashion; the basic laws of osmosis and turgor pressure from high school science class apply
here. Sodium regulates fluid balance within the body, is an electrical stimulator (with K+)
to nerve and muscle cells, and is monumental (as is K+) to the proper functioning of the
kidneys. Excessive sweating (from prolonged or intense exercise) can cause a pathological
state of blood sodium loss, referred to as "hyponatremia". You can correct this imbalance
either through preventive or curative means...by modifying the exercise to a less intense
regimen (decrease time spent exercising and amount of effort) and by administering direct
saline solution to the body, either by mouth or intravenously.
Potassium is essential for maintaining neuromuscular control and precise regulation of
skeletal, cardiac and smooth muscle activity. Because there is such a small quantity of
cellular K+ maintained in the body, any disruption of its regulation will result in a number
of neuromuscular and/or renal (kidney) problems. The kidneys are unable to conserve K+
during periods of acute loss and will continue to excrete it, even in a time of great need.
This means that a potassium deficit can develop rather quickly if its intake is inadequate.
"Hypokalemia" is the term referring to insufficient potassium concentration in the cells.
For the person taking laxatives, potassium loss should be their greatest worry; the liquid
stool can rid the body of 75% of its potassium stores, causing potentially permanent
damage, since it won't be conserved by the kidney. For those who do study physiology,
hypokalemia can also result in an impaired ability to increase blood flow during exercise, so
for the person with an ED who uses exercise as her method of purging, the K+ imbalance
can lead to decreased blood flow and ischemic injury to muscle cells, resulting in a loss of
smooth and skeletal muscle control.
After all has been said and done, what you CAN do, if you are someone who engages in any
of the above listed behaviours, is:
- BE AWARE! Know what you're doing to your body and try to understand that what
you think is a weight loss device is really depriving you of necessary fluids and ions that
help your body functioning -- and I mean BASIC functioning!! (heart beat, muscle
movement, coordination, etc)
- KEEP HYDRATED. Drink dilute, aqueous solutions containing electrolytes, simple
sugars and carbohydrates (during exercise, or throughout the day) to restore your blood
glucose, liver and muscle glycogen levels (simple sugars used up while moving) and to keep
you hydrated. Commercial sports drinks are good for this balance, and it's often helpful to dilute these with water to reduce the sodium concentration of the drink. If this idea scares you, then try to drink lots of water, and consume food high in ion content, like banana for K+ or other fruits for their simple sugar and water content.
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Last Updated July 31, 1999 by someone who's just a little more than FED-UP!