1. Do not use ipecac. That stuff can stop your heart. People only used it because it was a lesser of two evils: either certain death from whatever poison/toxin you ingested, or chance of death from the ipecac syrup yourself.
2. Do not induce vomit with foreign objects. This include things like tooth brushes and pens or swallowing candy on floss and pulling it out. You can inhale/swallow the object. An ER trip to remove a tooth brush is anything but pleasant.
3. Hand is your safe bet. It's disgusting, but it's the safest option if you can't purge hands free. You can't accidentally swallow or inhale your hand. If it's not working, it's usually due to:
- not sticking it down your throat far enough. I've gone as far as my teeth passing my knuckles by an inch.
- not leaving it in there long enough. Purging hurts and feels uncomfortable. Every inch of your body says remove your hand. Many people don't leave it in long enough their first few tries. I've left it in at least a minute, moving my fingers around my first time. It got easier after I got more practiced.
- removing it too soon. Many remove their hand the moment vomit starts coming up. Doing that can stop the flow of vomit. Suck it up and accept your hand will be covered in purge.
- not enough fingers. I use three. The joint of my ring finger catches on my teeth if I only use two.
- shot gag reflex. If you purge too often, your body builds tolerance to triggering your gag reflex. Take a 1-2, maybe 3 week break from purging for your gag reflex to return.
- things other than hand technique. Sometimes food is too difficult to purge (chocolate and bread are notorious). Better to compensate by exercising than hurt yourself with strain from vomiting.
4. Remove acid from hands and face. Wash your hand(s) asap. I wash between each "flow" of vomit. Your stomach acid can damage the skin on your hand over time. Best to remove it with hand soap. Wash your face. There will be tears and snot everywhere. Vomit can run on your chin or splash back, Wash with warm water and face cleanser (if you have one on hand). If your hair is long, it may also need a wipe if it wasn't tied back.
5. Protect your teeth and mouth. The acid can damage your tooth enamel, and purge can clog saliva glands. Rinse your mouth with water immediately. Take an antacid tablet (like tums) as according to directions. Antacid tablets or powders are calcium bicarbonate and will neutralize acid. Baking soda (sodium bicarbonate) dissolved in water works, too. If possible, gargle antacid on your throat, too. Your throat can get raw in a matter of minutes after purging. After 20-30 minutes, you can then brush your teeth. You have to wait because toothpaste has abrasives--gritty particles that scrape on teeth to "sandblast" plaque. The stomach acid softens your enamel, so brushing your teeth too soon can mean you "sandblast" your protective enamel.
6. saline rinse. Purge particles can get caught in your sinus cavities. Some people even had purge come out their noses. Your nose will naturally drip (a lot) during a purging session, but it may not be enough to clean your sinuses. You can get infections, bloody noses, and breathing problems from the purge. Rinse your sinuses with a neti pot or something similar if you can.
7. Drink water. Water makes food come up easier. Drink water (or other drink you fancy) during your binge if you can remember. Otherwise, chug a litter/quart of water and wait 5-15 minutes for it to mix in your stomach before you start to purge. Rinsing is when after your finish purging, you chug water again to purge and make sure you get it all out. Rinsing too much can remove even more electrolytes because you're removing even more stomach acid from your body. It's best to keep rinsing for emergencies.
8. Blood. Purging a tablespoon (14-15 ml) or more of blood means go to the emergency room now. A cut can get really nasty when acid can erode the flesh and bacteria can infect it. Bright red specks, streaks, or splotches is from the mouth or throat. Dark red or brown or black is stomach or lower stomach region. Blood can be a sign of cuts, ruptures, or ulcers. General rule: the darker, the further down and/or longer it's been in your system.
9. Stop purging when you experience the following:
- Heart fluttering (heart attack potential)
- dizzy or light-headed (fainting potential)
- blacking out during/after purging (take a few days break)
- lose sensation in your feet or legs (nerve damage from electrolyte imbalance)
- a tablespoon (14-15 ml) of blood (emergency room now!)
10. Electrolytes. Nerves use electrolytes to send signals. Without enough electrolytes, your nerves can't tell your muscles to contract. Guess what? Your heart is a muscle! You can be normal weight and still get a heart attack from purging. Electrolytes are also found in your stomach. Your body releases electrolytes during food digestion, but reabsorbs and recycles them. When your purge (vomit or laxatives), your body cannot reabsorb the electrolytes, and your electrolyte levels drop a LOT.
Sports drinks (Gatorade, Powerade, Mio, Hydrolyte, etc) offer some electrolytes, but they don't give as much as actual food. There are many no or low calorie versions out there. Food that hasn't been processed (fresh or cooked fruit, veggies, meat) provide much more electrolytes. Eating after purging may seem appalling, but drinking a sports drink is much better than nothing. Plus, the drinks soothe the sore throat and rinse the mouth of acid (if it's sugar-free version).
11. Get blood work. It's a good idea to check blood work for electrolyte balances with your regular doctor visits, especially if you purge several times a month or more. It can catch electrolyte imbalances early, and you can get proper supplements to correct them. Catching and correcting these health problems early means you prevent irreversible heart or nerve damage.
12. Avoid purging spicy or acidic food. They are notorious to hurt. Your throat is already raw from stomach acid. dumping spice and more acid is just going to hurt even more.
13. Careful with caffeine and alcohol. Purging a lot puts a lot of stress on your heart. Caffeine and other stimulants can put even more strain and can cause a heart attack or cardiac arrest. Alcohol is a depressant, and it can make your gag reflex slow. You run the risk of choking on your vomit, in addition to making poor decisions about whether to stop.
14. Make gravity work for you. Stand up, don't kneel over. When you're standing up, you can bend over at your hips and have gravity drag the vomit out of your stomach. One or two really good gags like this can get a LOT out. You don't have to keep gagging.
15. Make cleanup easy. Purge in plasticware. Collapsible ones are excellent for a purse or backpack. Many have markings to show volume, a bonus to help gauge how much you purged and how much to go. You can gently dump the purge down the toilet for minimal splatter and wash the container in the sink. A plastic container is more sanitary than a toilet, especially public toilets.
16. Cough drops. If your throat is still very sore, suck on a cough drop. Make sure it has menthol as an ingredient. Menthol is an anesthetic and will numb the area.
17. Have a purge kit. Have everything you may need for purging ready and in easy access. Water bottle, concentrated electrolyte sports drink (like mio or powerade drops), plastic container, towel, tissues, neti pot, antacid, makeup, lip balm, air freshener, gum, etc. The plastic container can double as the box holding everything.