Concept

Pseudo-Bartter Syndrome (PBS) in Eating Disorder Patients

Pseudo-Bartter syndrome results from chronic dehydration and thus sometimes presents in eating disorder patients, especially those who purge. It may cause hypokalemia and other electrolyte imbalances, and swelling when purging stops as a result of elevated aldosterone levels causing retention of water and salt. This edema, which can lead to weight gain and resulting emotional distress, can be avoided by less aggressive methods of fluid replacement such as a slow saline infusion of 50mL/hr in conjunction with 50-400mg low-dose spironolactone. These medications should then be gradually tapered off.

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Updated 2026-05-02

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