Binge Eating Disorder (Bulimia Nervosa): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin, mucous membranes, oral cavity, and sclera (white part of the eye) [accompanying symptoms: sialadenosis (salivary gland enlargement); scars on the back of the hand from repeated bite wounds; enamel recession; peripheral edema (water retention in tissues)] [due topossible sequelae: dental damage to the point of falling out of the teeth].
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
    • Inspection and palpation of the neck [due topossible sequelae: Hypertrophy (enlargement) of the parotid (parotid glands) and submandibular glands]
    • Auscultation (listening) of the heart [due tosymptom (rare) or possible sequelae: cardiac arrhythmias].
    • Auscultation of the lungs
    • Palpation (palpation) of the abdomen (stomach), etc. with an attempt to palpate the liver (pressure pain?, knocking pain?, coughing pain?, defensive tension?, hernial ports?, kidney bearing knocking pain?) [due todifferential diagnoses: hepatitis (liver inflammation), functional gastrointestinal disorders, gastritis (gastritis)].
    • Digital rectal examination (DRU) including inspection: examination of the rectum (rectum) [due todifferential diagnoses: chronic inflammatory bowel disease such as ulcerative colitis or Crohn’s disease].
  • If necessary, gynecological examination [due topossible symptoms (rare): oligomenorrhea (the interval between bleeding is > 35 days and ≤ 90 days, ie, too infrequent menstruation), amenorrhea (absence of menstruation)]
  • Psychiatric examination[due topossible cause: depression] [due todifferential diagnoses:
    • Acute adjustment disorder
    • Alcohol abuse (heavy drinking; alcohol abuse).
    • Anxiety disorders
    • Anorexia nervosa (Anorexia)
    • Depression
    • Substance abuse
    • Personality disorders
    • Schizophrenia (severe mental illness belonging to the endogenous psychoses and characterized by disturbances of thinking, perception and affectivity).
    • Nonspecific eating disorders
    • Obsessive-compulsive disorder]

    [due topossible sequelae:

    • Other addictive diseases
    • Anxiety disorders
    • Anorexia nervosa (Anorexia)
    • Depression
    • Impulse control disorders
    • Personality disorders
    • Recurrence (recurrence) of bulimia nervosa
    • Obsessive-compulsive disorder]
  • Health Check

Square brackets [ ] indicate possible pathological (pathological) physical findings.