Vomiting is the forcible voluntary or involuntary expulsion of stomach contents from the body, through the mouth. Almost everybody, at some point or time in their lives, has experienced an episode of vomiting. It is typically associated with another condition or underlying illness.
What is Vomiting?
Vomiting is a reflex that is controlled by the brain, and is a way for the body to eject unwanted elements and substances from the stomach. Emesis is the medical term for vomiting, and it is also commonly referred to as “being sick” and “throwing up.” Vomiting is closely related to nausea, although some causes of nausea do not produce vomiting.
During the process of vomiting, the natural movement of peristalsis is reversed. Peristalsis is a series of wave-like muscle contractions that move food through the digestive tract. The diaphragm muscle violently contracts and the abdominal muscles tighten and tense up, causing the intrusive substance to be driven up from the stomach, through the esophagus, and out of the body.
Most cases of vomiting do not last long, and typically clear up within 6 to 24 hours. If you experience vomiting for longer periods of time, seek medical care.
Anyone can experience vomiting, and it occurs in both children and adults. Vomiting is most commonly found in pregnant women and patients undergoing cancer treatments.
Patients who are vomiting have a greater risk of becoming dehydrated. Prudent monitoring of children and the elderly for signs of dehydration can reduce the risk of further or more serious complications.
It is possible to have reverse peristalsis of the stomach and esophagus without producing vomit. This is referred to a retching, or the dry heaves.
Sometimes vomiting is confused with coughing or spitting up mucus from the lungs. Vomiting only produces content from the stomach.
What Causes Vomiting?
While vomiting is not an illness in itself, it is often a symptom that accompanies many diseases and conditions. Some illnesses can cause vomiting, even if the illness itself does not directly involve the stomach or gastrointestinal tract. Patients experiencing the following conditions may experience vomiting:
- Viral infection
- Bacterial infection
- Motion sickness
- High fever
- Migraines or other headaches
- Food allergy
- Food poisoning
- Irritable bowel syndrome (IBS)
- Crohn’s Disease
- Meniere’s disease
- Brain tumor
- Concussion or other brain injury
- Benign paroxysmal positional vertigo (BPPV)
- Bulimia nervosa
- Ear infection (middle ear)
- Diabetic ketoacidosis
- Blocked intestine
- Peptic ulcer
- Alcohol poisoning
- Heart attacks
- Kidney disorders
- Liver disorders
- Gallbladder disease
- Central nervous system disorders
- Some forms of cancer
- Hydrocephalus (increased fluid in the brain)
- Stress, anxiety, or fear
- Chronic stomach conditions – diarrhea, constipation, and stomach problems
Certain medications may also cause patients to vomit, particularly when taking such medications on an empty stomach. General anesthesia given during a surgery may also induce vomiting in patients.
Patients undergoing cancer treatments such as chemotherapy or radiation have an increased chance of experiencing side effects such as vomiting.
Pregnant women often experience morning sickness, which also induces vomiting. This typically occurs during the first trimester, and as many as 25-55% of pregnant women experience vomiting during this time.
Exposure to certain toxic chemicals may also lead to vomiting. Even exposure to certain odors may cause a person to vomit.
Signs and Symptoms of Vomiting
The most obvious sign of vomiting is the experience of vomiting itself. Other symptoms that may accompany vomiting include:
- Sore abdominal muscles
- Rapid pulse
- Dry mouth
- Decreased urination
- Excessive sweating
Sometimes vomiting may even temporarily relieve symptoms of nausea.
Vomiting is not a disease, but it is a symptom of many conditions. Identifying other symptoms in addition to those listed above may help to determine the root cause of your vomiting.
Prevention of Vomiting
While sometimes vomiting cannot be prevented, and is often a healthy way for your body to expel toxins, there are certain methods that can be taken to reduce the onset of vomiting. Drinking clear liquids containing sugar can help to calm the stomach, particularly if you are already feeling nauseous. Try to avoid acidic juices, such as orange juice.
Resting or refraining from extreme physical activity can also help reduce vomiting if you are already feeling sick.
Children who experience motion sickness when riding in a car should be seated facing the front windshield.
After vomiting has stopped, a fluid diet is recommended for about 24 hours. Slowly add bland and soft foods, following the BRAT diet, which consists of bananas, rice, applesauce, toast, pasta, and potatoes. This can help prevent further episodes of vomiting or upsetting the stomach.
If you are feeling nauseous, try to avoid excessive motion, strong smells or tastes, and anxiety-producing situations. It is recommended that you remain sitting or propped up in a lying position.
Treatment of Vomiting
Treatment for vomiting can typically be done at home with rest and fluids. Try to gradually drink increased amounts of clear liquids, avoiding solid food until the vomiting subsides. Oral rehydration solutions are also an option to rehydrate and avoid dehydration, while replacing lost electrolytes.
Taking certain medications, such as nonsteroidal anti-inflammatory drugs, corticosteroids, and blood thinners may further upset your stomach and induce vomiting. This may also render such medications ineffective. Your medical provider may recommend temporarily suspending use of such oral medications. Speak with a medical provider before stopping any medications, especially those taken on a daily basis, to ensure this is safe.
Women who are vomiting due to morning sickness or pregnancy-related issues, patients suffering from motion sickness, or patients suffering from vertigo can use over-the-counter and prescription medications to control these symptoms. Such medications include promethazine (Phenergan), diphenhydramine (Benadryl), and trimethobenzamide (Tigan). Other medications for the treatment of vomiting include prochlorperazine (Compazine), ondansetron (Zofran), metoclopramide (Reglan), and hydroxyzine (Vistaril). Speak with a medical provider prior to starting such medications to ensure proper use and reduce the risk of side effects.
Vomiting that is due to surgery, radiation therapy, anticancer drugs, alcohol, and morphine can be treated with other medications, as directed by a medical professional.
Vomiting due to other underlying conditions may be resolved once the underlying condition is treated.
When Should I Call a Doctor?
Most cases of vomiting are not serious, and often go away with rest and hydration. However, if signs of vomiting do not improve after at-home care, consider speaking with a medical provider to determine the root cause of the vomiting.
Individuals should seek medical care if experiencing any of the following symptoms:
- Vomiting for longer than 24 hours
- Inability to eat or drink
- Inability to sleep due to consistent vomiting throughout the night
- Severe or persistent abdominal pain
- Pain associated with movement
- Reduced consciousness
- Fever higher than 100 degrees F (37.7 degrees C)
- If a child has not urinated in the last 6 hours
- Diarrhea in addition to vomiting
- Vomiting after recent head injury
Younger patients and the elderly are more susceptible to experiencing more severe side effects, such as dehydration, and should seek care as soon as possible if vomiting persists.
Patients with medical conditions such as heart disease, kidney disease, liver disease, or diabetes should also be evaluated by a medical provider if they experience persistent vomiting.
Consult a medical professional if you are pregnant, or may be pregnant, and are experiencing vomiting. A rare yet serious condition that some pregnant women experience through persistent vomiting is called hyperemesis gravidarum, where the mother develops fluid and mineral imbalances that may be dangerous to herself and her unborn child.
Another rare, but serious, complication from excessive vomiting is tearing or rupturing of the esophagus. Tearing of the lining of the esophagus is known as a Mallory-Weiss tear, and if this progresses to a rupturing of the esophagus, the condition develops into Boerhaave’s syndrome, which is a medical emergency.
If you experience any of the following symptoms, your condition may be more serious, and you should consult with a medical provider as soon as possible:
- Blood, bile, or any green or yellow substance appearing in vomit (vomit that is bright red or appears like “coffee grounds” warrant immediate medical attention)
- Fecal material or fecal odor in vomit
- Chest pain
- Blurred vision
- Severe headache
- Stiff neck, especially when accompanied by a high fever
- Cold, clammy, pale skin
- Confusion and/or extreme weakness
- Rapid breathing or pulse
- Severe dehydration
- Decreased responsiveness