Binge-eating and sodium bicarbonate: a potent combination for gastric rupture in adults—two case reports and a review of literature

Abstract

Plain English summary Disordered eating ranges from simple dieting to eating disorders. A large proportion of overweight or obese adolescents and young adults engage in disordered eating behaviours, most commonly binge-eating. While such behaviours can result in significant medical conditions, it commonly results in uncomfortable gastrointestinal symptoms. Over-the-counter medications are often used to relieve symptoms like indigestion, abdominal pain, and heartburn. Sodium bicarbonate, a common ingredient in these medications, has been associated with spontaneous stomach rupture. Despite this, sodium bicarbonate is suggested online as a home remedy for these symptoms. In this article we report two such cases of spontaneous stomach ruptures following the consumption of sodium bicarbonate containing antacids, following a large meal. We then review the literature for similar cases. We discuss the functional changes in the body resulting in the injury, the mortality rates, suggested management approaches and the relevance of our study. Our article emphasises the need for a low threshold of suspicion for patients presenting with severe abdominal pain with abdominal distension following a binge-eating episode. There is also a need to educate patients surrounding the use of over-the-counter medications or home remedies, as they are often unaware of potentially fatal adverse effects with inappropriate use.

Keywords

• Stomach rupture
• Gastric dilatation
• Sodium bicarbonate
• Feeding and eating disorders