Salivary and gustatory alterations among bulimia nervosa patients

Objective and design: This study systematically examined salivary composition and taste perception and monitored related subjective complaints in a group of bulimia nervosa (BN) patients. Subjects: Fifty-two consenting female individuals participated in the current cross-sectional study, 26 patients diagnosed with BN according to the Diagnostic and statistical manual of mental disorders-IV (DSM-IV) criteria (mean age: 24±7 years) and 26 healthy controls matching in age and body mass index (BMI). Methods: All participants were given diagnostic BN-related questionnaires, had taste and salivary-composition analyses and were monitored for oral sensorial complaints. The patients were also subjected to psychological and psychiatric examinations focusing on established criteria known to be pathognomonic of the disease (including binge eating episodes, depression, impulsive traits, enhanced awareness of body image, typical compensatory behavior, and so on). Results: The self-answered questionnaires of bulimic investigatory test Edinburgh (BITE), Beck Depression Inventory (BDI), brief symptom inventory (BSI) and impulsivity scale (IS) revealed highly significant differences between the two groups with respect to the various BN diagnostic symptoms of the patients (P=0.0001). Subjective and objective examinations showed an overall disturbed salivary and taste profile in BN patients, who complained of xerostomia (dry mouth) and taste aberration or oral burning sensation. Conclusions: Regardless of the specific mechanism responsible for the disturbed salivary and taste profile in BN patients, these observed changes are associated with active illness. Accordingly, administration of therapeutic agents, including antioxidants, anti-inflammatory drugs and saliva substitutes, to the oral cavity (and maybe even systemically) of BN patients should be considered.