Enlargement of salivary glands in bulimia

We report a unusual case of bulimia nervosa with bilateral swelling of parotid and submandibular glands as the only symptom of the underlying behavioural disorder. Histologically, sialadenosis was diagnosed in a parotid biopsy. The parotomegaly in bulimia may be a diagnostic primer as these patients often deny their eating disorder. B-scan ultrasonography is an important diagnostic tool to assess the nature of the parotid enlargement. Hyperamylasaemia occurs commonly in bulimic patients and may help to confirm the diagnosis. All patients with suspected bulimia should have a thorough medical history and physical examination to rule out other aetiologies of asymptomatic parotid swelling. As the enlargement is usually transient surgical intervention is only rarely required.