Eating Disorder Service
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Healthcare Professional's Area

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Advice on Managing Purging

Guidance for Clinicians Working Outside the Field of Eating Disorders

Overall, in managing a patient’s potassium level due to vomiting, laxative or diuretic abuse we would suggest the following:

  1. Advise the patient of the serious consequences of an abnormal potassium level and ensure that they have capacity to understand this and take appropriate steps to manage it.  Also ensure that they understand that a possible consequence of an abnormal potassium could be fatal due to cardiac arrest.
  2. Suggest regular checks of potassium and if the level is low, initially suggest stopping the purging behaviour.
  3. If the patient has reduced the purging behaviours as much as they can, we suggest the following guideline for management of the potassium.
  • If they have not as yet taken any potassium supplements use the following guide

Potassium level above 3mmol/L  -  Suggest repeat level in one week

Potassium level 2.5-3mmol/L  -  Suggest prescribe Slow-K or Sando-K, 2-4 tablets daily and repeat level in one week

Potassium level less than 2.5mmol/L  -  Suggest admission to medical ward for restabalisation and if patient refuses could be detained under the Mental Health Act for treatment

  • If the patient has been taking potassium supplements, it is important to clarify whether or not they have been compliant as patients are often non-compliant possibly because the supplements cause a side effect of nausea.  If the patient is compliant and the level is still below 3mmol/L, the dose may need to be increased and we usually increase it up to eight tablets daily.  If the patient is not compliant, we encourage compliance and repeat the level in one week’s time.
  • As well as potassium it is important to check a patient’s magnesium, calcium and phosphate level as these can all affect the absorption of potassium.