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Vomiting or taking laxatives regularly to try to stay thin is called purging. Purging can cause serious problems. After a while, things can go wrong with many different parts of your body.

Some people who have anorexia and some people with bulimia have the same kinds of problems because of purging. Here are some of the things that can happen.

• Vomit contains acid that can damage your teeth. Your teeth might turn kind of grey and they can look spotted. Acid also causes cavities (called dental caries). Any damage to your teeth is permanent.
• Losing all that acid can upset the balance of acids and alkalis in your body. (An alkali is the opposite of an acid.) If this imbalance gets severe enough, your muscles, heart and other organs can't work properly.
• If you don't replace the fluids you lose when you vomit, you'll get dehydrated. Severe dehydration can cause kidney failure.
• If you vomit often, you'll weaken the valve at the bottom of the tube (esophagus) that carries food from your mouth to your stomach. This weak valve allows acid in your stomach to splash up into your esophagus and damage the lining. This is called heartburn and it hurts.
• If you use your fingers to make yourself sick, you may get rough patches of skin on your knuckles.
• Violent vomiting can tear the lining of your esophagus and make you vomit blood. This doesn't happen often, but if it does, you can lose a lot of blood. That is very scary and it can be dangerous.

• If you take large amounts of laxatives regularly, you may not be able to digest food without them. You may get severely constipated.
• Laxatives cause diarrhea. Diarrhea is alkaline (the opposite of acidic). Losing all that alkali eventually upsets the balance of acid and alkali in your body. A very serious upset in this balance can mean your heart may not work properly.
• Diarrhea is mostly water, so laxatives can make you dehydrated. Bad dehydration causes kidney failure. This type of kidney failure often gets better, but some people will have permanent kidney failure. If this happens, you'll need dialysis (where a machine is used to to clean your blood) or a kidney transplant.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.