Eating disorder and breathing issues

[d0ttysslave]

Hello,

This question is not about me, but rather it concerns my 21 year old son. My son has asthma and a, now chronic, eating disorder (bulimia nervosa). To complicate matters, he also has a debilitating anxiety disorder, classified as GAD, because he is anxious about everything, but, he is particularly concerned about his health.

For some time, his bulimic behaviour has seemed to affect his breathing. I think it is bound to, due to fluctuating blood sugars, pressure on the diaphragm and possible issues with blood gases and electrolytes.

When his breathing is bad, after a period of bulimic/purging behaviour, he literally gasps for air and has to grip onto something. I had thought this was something to do with his asthma, but yesterday, he showed me an article on 'Kussmaul breathing' and it scared me a little. My son is reacting in his usual way: convinced this is what he has and panicking.

I am going to contact the doctor today, and hope that my son may at least agree to have a blood test (despite his anxiety, he avoids going to the GP), but I was wondering if anyone could tell me whether, in your opinion/experience, my son's prolonged attacks of breathlessness/gasping are more likely to be related to his anxiety than to metabolic acidosis.

Thank you

[sassy59]

I’m afraid I don’t know the answer to your question but just wanted to say how sorry I am to hear about your sons health issues. I hope he can get help and support from doctors and wish him and you better days ahead. Take care xxxx❤️

[knitter]

Could you give the ALUK helpline a ring .

They will be open soon for UK residents on 0300 222 5800.

Check in with your GP first though .

Best wishes .

[Alberta56]

I can't give medical advice on what sounds like a very complicated issue, but I'm sorry to hear that you have this to deal with and hope that your doctors can give you some help quickly. Best wishes to you and your son. xxx

[Badbessie]

I am not an expert. From experience it is more likely due to anxiety. Metabolic acidosis normally as an underlying cause for example kidney failure, shock etc. The breathing pattern is a result of the acidosis not the cause. There are other symptoms of acidosis most of which are a cross over with anxiety, fast pulse etc. The important thing is the acidosis will not go away without correction so if the breathing problems are intermittent then it is anxiety.

[d0ttysslave]

Thank you. My son has got up and is just going through a few of his routines. He has agreed for me to call the doctor when he has had a shower. @Badbessie, he is breathing perfectly well now, so probably we are dealing with anxiety or something else.

[Hidden]

With the caveat that I’m not medically qualified. I agree with badbessie: kussmaul breathing is usually a symptom of an underlying physical problem causing acidosis, not the other way round. In reality, anxiety can have a massive impact on breathing patterns, even to the point of effecting oxygen saturations. My teen has a lung disease, but kept getting really breathless beyond what her lung damage at that time would have warranted. After testing, it transpired anxiety was causing dysfunctional breathing patterns to the point that her sats were dropping below 90%. It’s not always obvious: she attends arguably one of the best respiratory specialist hospitals in the world, they’re highly familiar with DB, and the only way they actually picked it up was by sticking her in a lab to do a formal cardiopulmonary exercise test. The good news is that if it is DB, then it’s just a case of retraining them to breathe ‘properly’ again, which can usually be done over the course of a few months. In our case, just knowing for sure what the cause was went a long way to solving the problem. However, with an eating disorder, it needs to be run past a doctor for a professional opinion, regardless - it’s possible your son has nutrient deficiencies due to purging that could be playing a part. At the very least I would suggest he needs some blood tests running to look at that angle, as well as the usual measures of kidney and liver function etc. I hope he gets the help needed to start to recover soon.

[d0ttysslave]

Thank you again. Yes, I agree. I will get a call back from the GP this afternoon, but I think my son does need to consider the impact his ED has as well. His breathing difficulties have got worse as his bingeing and vomiting have increased, so there may very well be a connection, as well as the impact of his anxiety disorder.

Best wishes to you and your daughter Charlie _G.