"I ate so much I'm about to burst!"
Someone at your Thanksgiving table will likely say some version of this tomorrow, after you've all stuffed your faces with turkey, mashed potatoes, sweet potatoes and the rest. But how much would you have to eat in order for your stomach to actually burst? Is that even possible?
"Interestingly enough, you can rupture your stomach if you eat too much," says Dr. Rachel Vreeman, co-author of "Don't Cross Your Eyes ... They'll Get Stuck That Way!" and assistant professor of pediatrics at Indiana University School of Medicine. "It is possible, but it's very, very rare."
A handful of reports over the years document the tales of people who literally ate themselves to death, or at least came dangerously close: Japanese doctors wrote in a 2003 case report that they believed it was a 49-year-old man's "excessive over-eating" that caused his stomach to rupture, killing him. And this 1991 case report describes a similar "spontaneous rupture" in an adult's stomach "after overindulgence in food and drink."
Normally, your stomach can hold about one or one-and-a-half liters, Vreeman says -- this is the point you may reach if you overdo it tomorrow, when you feel full to the point of nausea. Pathologists' reports seem to suggest the stomach is able to do OK handling up to about three liters, but most cases of rupture seem to occur when a person has attempted to stuff their stomach with about five liters of food or fluid. (One of the reports Vreeman came across described the sad case of a woman whose stomach contained 12 liters of stuff.)
It takes a certain amount of misguided determination to manage to override your natural gag reflex and continue to eat (and eat and eat), which is why, not surprisingly, reports of ruptured stomachs caused by overeating are most common in people with some sort of disordered eating, or limited mental capacity, Vreeman says.
"They have unusual eating habits to an extent that their bodies’ reflexes no longer respond as they normally do," Vreeman explains. "Their bodies’ reflexes have been ignored or abused for so long that they no longer vomit at the appropriate time. And then once the stomach gets to this extremely distended point, the stomach muscles are too stretched out to be strong enough to vomit the food out."
Speaking of strong stomachs, you'd best have one in order to read this next paragraph. If vomiting isn't happening, all that food and fluid still has to go somewhere. The increasing volume of stuff in the gut puts pressure on the stomach's walls, so much so that the tissue weakens and tears, sending the stomach contents into the body and causing infection and pain, Vreeman says. Surgical intervention is necessary to repair a ruptured stomach and save the patient's life.
In particular, she says, anorexics or bulimics may be at risk. In fact, Cedars-Sinai, the non-profit hospital in Los Angeles, actually lists this as a "symptom" of bulimia: "In rare cases, a person may eat so much during a binge that the stomach bursts or the esophagus tears. This can be life-threatening."
Other reported cases of spontaneous stomach rupture happen in individuals with Prader-Willi syndrome, a congenital disease that is characterized by, among other things, a kind of disordered eating: an "intense craving for food," resulting in "uncontrollable weight gain and morbid obesity." according to the National Institutes of Health. In a 2007 study examining the deaths of 152 individuals with the condition, 3 percent of those deaths were the result of gastric rupture and necrosis.
The takeaway here: This really happens, sometimes! Also: This is probably not going to happen to you.
"Even if you're starting to feel a bit sick or tired and overwhelmed from eating so much at Thanksgiving, you're still far, far away from the scenario where you're going to make your stomach actually explode," Vreeman assures.