What are the common causes of vomiting. How is vomiting diagnosed. What are the different types of vomit. When should you seek medical attention for vomiting. How can you prevent and treat vomiting at home.

Understanding Vomiting: Definition and Types

Vomiting, also known medically as “emesis,” is the forceful expulsion of stomach contents through the mouth or, less commonly, the nose. This involuntary reflex can be triggered by various factors and manifests in different forms:

• Dry heaves: Retching without producing any stomach contents
• Productive emesis: Expulsion of stomach contents
• Blood-streaked vomit: Indicates potential injury to the esophagus or stomach
• Coffee ground vomit: Appears dark and granular, suggesting the presence of partially digested blood
• Yellow vomit: Contains bile, often occurring on an empty stomach

Understanding these types can help identify underlying causes and determine the appropriate course of action.

Recognizing the Symptoms Associated with Vomiting

Vomiting rarely occurs in isolation. It is often accompanied by a constellation of symptoms that can provide insight into its underlying cause. Common accompanying symptoms include:

• Nausea
• Abdominal pain
• Diarrhea
• Fever
• Light-headedness
• Vertigo
• Rapid pulse
• Excessive sweating
• Dry mouth
• Decreased urination
• Chest pain
• Fainting
• Confusion
• Excessive sleeping

Are these symptoms always present with vomiting? No, the combination and severity of symptoms can vary depending on the underlying cause and individual factors. Recognizing these associated symptoms can aid in proper diagnosis and treatment.

Exploring the Diverse Causes of Vomiting

Vomiting can be triggered by a wide array of factors, ranging from minor irritations to serious medical conditions. Some common causes include:

1. Infections (e.g., influenza, gastroenteritis)
2. Food poisoning
3. Early stages of pregnancy
4. Medication side effects
5. Intense pain
6. Emotional stress
7. Gallbladder disease
8. Concussions or brain injuries
9. Migraines
10. Motion sickness
11. Chemotherapy and radiotherapy
12. Eating disorders (e.g., bulimia)
13. Gastroesophageal reflux disease (GERD)
14. Stomach or liver cancer
15. Kidney infections or stones

Can vomiting be a sign of a heart attack? Yes, in some cases, vomiting can be a symptom of a heart attack, especially when accompanied by chest pain, shortness of breath, and sweating. If you suspect a heart attack, seek immediate medical attention.

Diagnostic Approaches for Vomiting

When persistent vomiting requires medical attention, healthcare providers employ various diagnostic methods to determine its underlying cause:

• Medical history review
• Physical examination
• Medication review
• Blood tests
• Urine tests
• Pregnancy test (for women of childbearing age)

Doctors also assess for signs of dehydration, which can be a serious complication of prolonged vomiting. These signs may include:

• Dry skin
• Cracked lips
• Dark-colored urine
• Dizziness
• Fatigue
• Abnormal sweating and urination patterns

How long should you wait before seeking medical attention for vomiting? Generally, if vomiting persists for more than 24 hours in adults or a few hours in infants and young children, it’s advisable to consult a healthcare provider.

Treatment Strategies for Vomiting

The treatment for vomiting depends on its underlying cause and severity. In many cases, home remedies and over-the-counter treatments can provide relief:

• Rest and avoid solid foods temporarily
• Stay hydrated with clear fluids or oral rehydration solutions
• Gradually reintroduce bland foods (BRAT diet: Bananas, Rice, Applesauce, Toast)
• Over-the-counter antiemetics (e.g., dimenhydrinate, meclizine)
• Ginger or peppermint tea

For more severe cases or those caused by underlying medical conditions, medical treatments may include:

• Intravenous fluids for dehydration
• Prescription antiemetics
• Treatment of the underlying condition (e.g., antibiotics for infections)

Is it safe to drink water immediately after vomiting? While staying hydrated is crucial, it’s best to wait about 15-30 minutes after vomiting before sipping small amounts of water or sucking on ice chips. This allows the stomach to settle and reduces the likelihood of triggering further vomiting.

Preventing Vomiting: Strategies and Lifestyle Changes

While not all instances of vomiting can be prevented, certain measures can reduce the risk:

• Practice good hygiene to prevent infections
• Eat a balanced diet and avoid overeating
• Manage stress through relaxation techniques
• Stay hydrated
• Avoid known triggers (e.g., certain foods, strong odors)
• Take motion sickness precautions when traveling
• Follow medication instructions carefully

For those prone to migraines or other conditions that can cause vomiting, working with a healthcare provider to develop a preventive strategy can be beneficial.

When to Seek Immediate Medical Attention for Vomiting

While most cases of vomiting resolve on their own, certain situations warrant immediate medical attention:

• Signs of severe dehydration (e.g., extreme thirst, dark urine, dizziness)
• Vomiting blood or coffee ground-like material
• Severe abdominal pain
• High fever (above 101.5°F or 38.6°C)
• Vomiting after a head injury
• Suspected poisoning
• Inability to keep any fluids down for 24 hours
• Signs of a heart attack or other serious conditions

For infants and young children, additional red flags include:

• Vomiting for more than a few hours
• Signs of dehydration (e.g., no tears when crying, dry mouth, no wet diapers for 3 hours)
• Projectile vomiting
• Lethargy or unresponsiveness

How can you differentiate between normal vomiting and a medical emergency? Pay attention to the duration, frequency, and accompanying symptoms. If in doubt, it’s always better to err on the side of caution and seek medical advice.

Understanding the Impact of Vomiting on Overall Health

While often temporary, vomiting can have significant effects on the body if prolonged or severe:

• Dehydration and electrolyte imbalance
• Malnutrition
• Damage to tooth enamel due to stomach acid exposure
• Esophageal irritation or tears
• Aspiration pneumonia (if vomit is inhaled into the lungs)

These potential complications underscore the importance of proper management and timely medical intervention when necessary.

Vomiting in Special Populations

Certain groups may require special consideration when it comes to vomiting:

Pregnant Women

Morning sickness is common in early pregnancy, but severe, persistent vomiting (hyperemesis gravidarum) can lead to dehydration and nutritional deficiencies. Pregnant women experiencing severe vomiting should consult their healthcare provider.

Children

Children, especially infants, are more susceptible to dehydration from vomiting. Parents should monitor fluid intake and output closely and seek medical attention if signs of dehydration appear.

Elderly Individuals

Older adults may be more vulnerable to complications from vomiting due to underlying health conditions or medications. They should be monitored closely and medical advice sought if vomiting persists.

The Role of Diet in Managing and Preventing Vomiting

Dietary choices can play a significant role in both preventing and managing episodes of vomiting:

• Avoid trigger foods: Identify and avoid foods that commonly cause digestive upset.
• Eat smaller, more frequent meals: This can help prevent overloading the stomach.
• Stay hydrated: Drink clear fluids regularly, especially in hot weather or during illness.
• Consider probiotics: These may help maintain a healthy gut flora and reduce the risk of certain types of vomiting.

During recovery from a bout of vomiting, following the BRAT diet (Bananas, Rice, Applesauce, Toast) can help ease the digestive system back to normal functioning.

Psychological Aspects of Vomiting

Vomiting isn’t always purely physiological. Psychological factors can play a role in both causing and perpetuating vomiting:

• Anxiety and stress can trigger nausea and vomiting in some individuals.
• Eating disorders like bulimia nervosa involve self-induced vomiting.
• Fear of vomiting (emetophobia) can lead to anxiety and avoidance behaviors.

Addressing these psychological aspects may be crucial in managing certain cases of chronic or recurrent vomiting.

Alternative and Complementary Approaches to Managing Vomiting

While medical treatments are often necessary, some individuals find relief through alternative or complementary approaches:

• Acupressure: Applying pressure to the P6 (Nei Kuan) point on the inner wrist may help alleviate nausea and vomiting.
• Aromatherapy: Certain scents like peppermint or lemon may help reduce nausea.
• Herbal remedies: Ginger and peppermint are commonly used to soothe upset stomachs.
• Mindfulness and relaxation techniques: These may help manage stress-related nausea and vomiting.

It’s important to consult with a healthcare provider before trying any alternative treatments, especially if you have underlying health conditions or are taking medications.

The Impact of Medications on Vomiting

Many medications can cause nausea and vomiting as side effects. Common culprits include:

• Antibiotics
• Opioid pain medications
• Chemotherapy drugs
• Nonsteroidal anti-inflammatory drugs (NSAIDs)

If you suspect a medication is causing vomiting, don’t stop taking it without consulting your healthcare provider. They may be able to adjust the dosage, switch to an alternative medication, or provide strategies to manage the side effects.

Vomiting in the Context of Global Health

Vomiting, particularly when accompanied by diarrhea, remains a significant health concern globally, especially in developing countries:

• It’s a common symptom of waterborne diseases, which affect millions worldwide.
• In areas with limited access to healthcare, complications from vomiting (like severe dehydration) can be life-threatening.
• Public health initiatives focusing on clean water, sanitation, and hygiene (WASH) play a crucial role in preventing many causes of vomiting.

Understanding vomiting in this broader context highlights the importance of global health initiatives in preventing and managing this common but potentially serious symptom.

The Future of Vomiting Treatment and Prevention

Ongoing research continues to explore new approaches to treating and preventing vomiting:

• Development of more targeted antiemetic medications with fewer side effects
• Investigation of the gut-brain axis and its role in nausea and vomiting
• Exploration of genetic factors that may predispose individuals to certain types of vomiting
• Advancements in understanding and treating cyclic vomiting syndrome

These areas of research hold promise for improving the management of vomiting and related conditions in the future.

In conclusion, while vomiting is a common and often benign symptom, it can sometimes signal serious underlying conditions. Understanding its causes, recognizing when to seek medical attention, and knowing how to manage it effectively are crucial for maintaining overall health and well-being. By staying informed and attentive to your body’s signals, you can navigate episodes of vomiting with greater confidence and ensure timely intervention when necessary.

What Is Vomiting? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Medically Reviewed

Vomiting is rarely painful, but never pleasant. Vomiting, also known medically as “emesis” and colloquially as throwing up, retching, heaving, hurling, puking, tossing, or being sick, is the forcible voluntary or involuntary emptying of stomach contents through the mouth or, less often, the nose.

There are different types of vomiting. Some people get the dry heaves, where you retch and feel like vomiting, but nothing comes out of your stomach. The dry heaves are also called nonproductive emesis.

Blood streaked or bloody vomit usually indicates a cut or scrape to the esophagus or stomach. Some vomit resembles coffee grounds. Vomit that looks like coffee grounds occurs when stomach acids and blood congeal. Coffee ground vomit can be a sign of ulcer, gastroesophageal reflux disease (GERD), cancer of the stomach or liver, or other abdominal conditions.

Yellow vomit indicates the presence of bile, which usually happens after a meal.

It’s rare, but people with abnormal intestinal function may vomit up partially digested food or feces. (1,2)

Signs and Symptoms of Vomiting

Nausea and vomiting commonly occur in those with infections ranging from influenza to gastroenteritis. Symptoms that occur with nausea and vomiting include:

• Abdominal pain
• Diarrhea
• Fever
• Light-headedness
• Vertigo
• Rapid pulse
• Excessive sweating
• Dry mouth
• Decreased urination
• Chest pain
• Fainting
• Confusion
• Excessive sleepiness

Common Questions & Answers

What causes you to vomit?

The causes of vomiting vary widely. They include food poisoning, infections like the flu or gastroenteritis, stress, pain, motion sickness, migraines, chemotherapy, the early stages of pregnancy, and certain medications.

When is vomiting serious?

While most vomiting isn’t anything to worry about, it can be a sign of serious issues like concussions, gallbladder disease, ulcers, and heart attacks. During pregnancy it can also be a symptom of hyperemesis gravidarum, which is a severe form of morning sickness.

What is vomit made of?

Vomit is made up of the contents of your stomach.

What are the different types of vomiting?

With dry heaves, you might retch without anything coming out of your stomach. Yellow vomit indicates the presence of bile; this can happen on an empty stomach. Vomit that resembles coffee grounds may be a sign of ulcers, GERD, or stomach or liver cancer.

Should I drink water after vomiting?

Vomiting can cause dehydration, so drinking water afterward is generally recommended. But it’s important to let your stomach recover. For the first three to four hours post-vomiting, try sipping water every 15 minutes (or suck on ice chips). Increase fluids when you feel up to it.

Causes and Risk Factors of Vomiting

Vomiting is an involuntary reflex that empties the stomach forcefully. Some people may also self-induce vomiting because of an eating disorder. According to the Mayo Clinic, causes for nausea and vomiting vary widely and can include: (3)

• Early stages of pregnancy
• Medication-induced vomiting
• Intense pain
• Emotional stress (such as fear)
• Gallbladder disease
• Food poisoning
• Infections (such as the “stomach flu”)
• Overeating
• A reaction to certain smells or odors
• Heart attack
• Concussion or brain injury
• Brain tumor
• Ulcers
• Some forms of cancer
• Bulimia or other psychological illnesses
• Gastroparesis or slow stomach emptying (a condition that can be seen in people with diabetes)
• Ingestion of toxins or excessive amounts of alcohol
• Migraines
• Labyrinthitis, which also causes dizziness and a feeling of spinning (vertigo)
• Motion sickness, nausea and vomiting associated with traveling
• Certain medicines, such as antibiotics and opioid painkillers
• Kidney infections and kidney stones
• A blockage in your bowel, which may be caused by a hernia or gallstones
• Chemotherapy and radiotherapy
• An inflamed gallbladder (acute cholecystitis)

How Is Vomiting Diagnosed?

If you need to see a doctor for vomiting, they will take your medical history and perform a physical exam to find the underlying cause. A history of your medication will be taken to see if vomiting is a side effect.

Blood and urine tests may be done to look for signs of infection. Women may also take a pregnancy test. (1)

Your doctor will also look for signs of dehydration, including dry skin, cracked lips, dark-colored urine, dizziness, fatigue, and sweating and urinating more than usual, according to the National Institutes of Health (NIH). (4)

Duration of Vomiting

Typically, vomiting eases within 6 to 24 hours with at-home treatment. If vomiting occurs for more than a day, you should see a doctor for further evaluation. They’ll discuss whether you need treatment or tests.

Call your pediatrician if your infant or young child experiences vomiting for more than a few hours or if they are vomiting with a fever higher than 100 degrees F, notes the Cleveland Clinic. (5)

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Treatment and Medication Options for Vomiting

Treatment for nausea and vomiting depends on the underlying cause.

Most episodes of vomiting can be treated at home. Self-care measures you can take to treat vomiting include:

• Drink plenty of liquids to avoid dehydration.
• Adhere to a clear liquid diet to rest the stomach.
• Avoid strong odors, including food and cooking smells, perfume, and smoke, that could possibly trigger vomiting.
• When you begin eating solid food again, stick to bland foods that are easily digestible, like cereal, rice, and crackers.
• Avoid spicy and fatty foods.

If you are planning a trip and have a history of motion sickness, try over-the-counter medications to treat the condition, like dimenhydrinate (sold as Dramamine) and meclizine. For longer journeys like cruises, your doctor may prescribe an adhesive patch to treat motion sickness.

Vomiting associated with cancer treatments can often be treated with another type of drug therapy.

There are also prescription and nonprescription drugs that can be used to control vomiting associated with pregnancy. These include vitamin B6 supplements, and a drug that combines B6 and doxylamine. Doxylamine is an antihistamine that’s sold as Unisom, an insomnia treatment. Ginger supplements have also been shown to help. (6, 7)

Consult with a doctor before using any of these treatments.

Severe dehydration caused by vomiting may require treatment with intravenous fluids. (8)

Prevention of Vomiting

A person with nausea has the sensation that vomiting may occur. Other signs that you are about to vomit include gagging, retching, choking, involuntary stomach reflexes, the mouth filling with saliva (to protect the teeth from stomach acid), and the need to move or bend over.

If you feel nauseated, resting either in a sitting position or in a propped lying position can help; activity may worsen nausea and may lead to vomiting.

Pregnant women experiencing morning sickness can eat some crackers before getting out of bed or eat a high protein snack before going to bed (like lean meat or cheese). (8)

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Complications of Vomiting

One of the biggest complications of vomiting is dehydration, which occurs when the body loses more water than it takes in. When someone is dehydrated, their body does not have enough water to carry out its normal functions.

Anyone can become dehydrated, but it is especially dangerous for younger children because they may not be able to tell an adult their symptoms. Older adults are also at an increased risk of dehydration because they have a lower volume of water in their bodies than younger adults. Older adults may also have medical conditions or take medications that make dehydration more likely.

Mild or moderate dehydration can often be reversed by drinking plenty of fluids, but severe dehydration can turn deadly and requires immediate medical treatment.

Repetitive vomiting, such as that comes with certain eating disorders like bulimia, can lead to malnutrition, dangerous weight loss, stomach ulcers, erosion of tooth enamel, and esophagitis. (4)

In certain circumstances, vomiting itself can become deadly. The gag reflex during vomiting prevents the liquid contents of your stomach from entering your respiratory tract and suffocating you. People who vomit under the influence of drugs or alcohol, or who vomit while on their backs, are at risk of choking on their own vomit because this gag reflex is not intact.

Resources We Love

Favorite Organizations for Information on Vomiting

American Cancer Society (ACS)

ACS is a nationwide organization dedicated to advocating for cancer patients and eliminating cancer as a major health problem. People living with cancer can get information about why their condition and medications may lead to nausea and vomiting, as well as tips on how to cope. ACS also offers patients advice on how to talk to their healthcare team and loved ones about their symptoms.

March of Dimes

For 80 years, March of Dimes has been a leading advocacy organization for the health of all mothers and babies. Their website offers pregnant women an outlet to learn all about morning sickness, including what is normal and when vomiting may affect their health and the health of their baby.

National Eating Disorders Association (NEDA)

NEDA is the largest nonprofit organization dedicated to supporting those affected by eating disorders and their families. Get the facts about bulimia, an eating disorder characterized by episodes of bingeing and self-induced purging, including diagnostic criteria, warning signs and symptoms, and health effects of the condition.

National Organization for Rare Disorders (NORD)

NORD is a patient advocacy organization dedicated to individuals with rare disorders and conditions. Read all the essential facts on cyclic vomiting syndrome, including symptoms, causes, diagnosis, prevention, and treatment.

Additional reporting by Brian Joseph Miller.

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Nausea and Vomiting – Common Causes and How To Treat It

Written by WebMD Editorial Contributors

• What Causes Nausea or Vomiting?
• Is Vomiting Harmful?
• When to Call the Doctor About Nausea and Vomiting
• How Is Vomiting Treated?
• How Can I Prevent Nausea?
• How Do I Prevent Vomiting Once I Feel Nauseated?
• More

Nausea is an uneasiness of the stomach that often comes before vomiting. Vomiting is the forcible voluntary or involuntary emptying (“throwing up”) of stomach contents through the mouth.

Nausea and vomiting are not diseases, but they are symptoms of many conditions such as:

• Motion sickness or seasickness
• Early stages of pregnancy (nausea occurs in approximately 50%-90% of all pregnancies; vomiting in 25%-55%)
• Medication-induced vomiting
• Intense pain
• Emotional stress (such as fear)
• Gallbladder disease
• Food poisoning
• Infections (such as the “stomach flu”)
• Overeating
• A reaction to certain smells or odors
• Heart attack
• Concussion or brain injury
• Brain tumor
• Ulcers
• Some forms of cancer
• Bulimia or other psychological illnesses
• Gastroparesis or slow stomach emptying (a condition that can be seen in people with diabetes)
• Ingestion of toxins or excessive amounts of alcohol
• Bowel obstruction 
• Appendicitis

The causes of vomiting differ according to age. For children, it is common for vomiting to occur from a viral infection, food poisoning, milk allergy, motion sickness, overeating or feeding, coughing, or blocked intestines and illnesses in which the child has a high fever.

The timing of the nausea or vomiting can indicate the cause. When appearing shortly after a meal, nausea or vomiting may be caused by food poisoning, gastritis (inflammation of the stomach lining), an ulcer, or bulimia. Nausea or vomiting one to eight hours after a meal may also indicate food poisoning. However, certain food- borne bacteria, such as salmonella, can take longer to produce symptoms.

Usually, vomiting is harmless, but it can be a sign of a more serious illness. Some examples of serious conditions that may result in nausea or vomiting include concussions, meningitis (infection of the membrane linings of the brain), intestinal blockage, appendicitis, and brain tumors.

Another concern is dehydration. Adults have a lower risk of becoming dehydrated, because they can usually detect the symptoms of dehydration (such as increased thirst and dry lips or mouth). But young children have a greater risk of becoming dehydrated, especially if they also have diarrhea, because they often are unable to communicate symptoms of dehydration. Adults caring for sick children need to be aware of these visible signs of dehydration: dry lips and mouth, sunken eyes, and rapid breathing or pulse. In infants, also watch for decreased urination and a sunken fontanelle (soft spot on top of the baby’s head).

Recurrent vomiting in pregnancy can lead to a serious condition called hyperemesis gravidarum in which the mother may develop fluid and mineral imbalances that can endanger their life or that of their unborn child.

Rarely, excessive vomiting can tear the lining of the esophagus, also known as a Mallory-Weiss tear. If the esophagus is ruptured, this is called Boerhaave’s syndrome, and is a medical emergency.

Call a doctor about nausea and vomiting:

• If the nausea lasts for more than a few days or if there is a possibility of being pregnant
• If home treatment is not working, dehydration is present, or a known injury has occurred (such as head injury or infection) that may be causing the vomiting
• Adults should consult a doctor if vomiting occurs for more than one day, diarrhea and vomiting last more than 24 hours, or there are signs of dehydration.
• Take an infant or child under six years to the doctor if vomiting lasts more than a few hours, diarrhea is present, signs of dehydration occur, there is a fever, or if the child hasn’t urinated for 4-6 hours.
• Take a child over age six years to the doctor if vomiting lasts one day, diarrhea combined with vomiting lasts for more than 24 hours, there are any signs of dehydration, there is a fever higher than 101 degrees, or the child hasn’t urinated for six hours.

You should seek immediate medical care if any of the following situations occur with vomiting:

• There is blood in the vomit (bright red or “coffee grounds” in appearance)
• Severe headache or stiff neck
• Lethargy, confusion, or a decreased alertness
• Severe abdominal pain
• Diarrhea
• Rapid breathing or pulse

Treatment for vomiting (regardless of age or cause) includes:

• Drinking gradually larger amounts of clear liquids
• Avoiding solid food until the vomiting episode has passed
• If vomiting and diarrhea last more than 24 hours, an oral rehydrating solution such as Pedialyte should be used to prevent and treat dehydration.
• Pregnant women experiencing morning sickness can eat some crackers before getting out of bed or eat a high protein snack before going to bed (lean meat or cheese).
• Vomiting associated with cancer treatments can often be treated with another type of drug therapy. There are also prescription and nonprescription drugs that can be used to control vomiting associated with pregnancy, motion sickness, and some forms of dizziness. However, consult with a doctor before using any of these treatments.

There are several ways to try and prevent nausea from developing:

• Eat small meals throughout the day instead of three large meals.
• Eat slowly.
• Avoid hard-to-digest foods.
• Consume foods that are cold or room temperature if you are nauseated by the smell of hot or warm foods.
• Rest after eating with your head elevated about 12 inches above your feet.
• Drink liquids between meals rather than during meals.
• Try to eat when you feel less nauseated.

When you begin to feel nauseated, you may be able to prevent vomiting by:

• Drinking small amounts of clear, sweetened liquids such as soda or fruit juices (except orange and grapefruit juices, because these are too acidic)
• Resting either in a sitting position or in a propped lying position; activity may worsen nausea and may lead to vomiting.

To prevent nausea and vomiting in children:

• To treat motion sickness in a car, seat your child so they face the front windshield (watching fast movement out the side windows can make the nausea worse). Also, reading or playing video games in the car could cause motion sickness.
• Don’t let kids eat and play at the same time.

Top Picks

Nausea and vomiting

Nausea is a painful sensation in the stomach and throat, which may be accompanied by weakness, increased salivation, sweating and often precedes vomiting.

Vomiting is a sudden involuntary emptying of the stomach.

Nausea and vomiting are symptoms of many diseases and conditions, from pregnancy to serious pathologies such as brain tumors, epilepsy and myocardial infarction.

In most cases, nausea and vomiting are not harmful to the body. However, prolonged vomiting, often in combination with diarrhea, can lead to severe dehydration and, as a result, disruption of the cardiovascular system, brain, kidneys and other organs. This is especially true for young children, who themselves cannot control the manifestations of dehydration. Pregnant women may experience so-called excessive vomiting of pregnant women, which disrupts the balance of electrolytes in the blood and threatens the life of the mother and fetus.

There are medicines available that can reduce nausea. However, in any case, it is necessary to find out its cause.

English synonyms

Nausea, emesis, vomiting, vomitus, distaste, sickness, retching, bdelygmia.

Symptoms

The duration of nausea and vomiting, the timing of their onset, and the effect of eating on them depend on their underlying cause. For example, nausea and / or vomiting almost immediately after eating may indicate gastritis (inflammation of the gastric mucosa), within 1-8 hours after eating – poisoning.

Prolonged vomiting may cause signs of dehydration:

• dry mouth;
• thirst;
• sunken eyes;
• infrequent urination, decreased amount of urine, dark urine;
• in children, the fontanel can sink in – a soft area at the junction of the child’s cranial bones, which normally closes by 12-18 months of age.

There are also a number of symptoms that are signs of dangerous, life-threatening conditions and require immediate medical attention:

• admixture of blood in vomit;
• severe headache, confusion, impaired consciousness;
• abdominal pain;
• signs of dehydration;
• shortness of breath;
• Vomiting that lasts longer than a day (for children, if it lasts for several hours, especially in combination with diarrhea and fever).

Most often, vomiting and nausea resolve within 6-24 hours. If these symptoms recur within a week and if you suspect a possible pregnancy, you should also seek medical advice.

General information about the disease

Nausea occurs when there is a decrease or absence of gastric peristalsis with simultaneous tension of the initial part of the intestine – the duodenum, which is accompanied by the reflux of part of the contents of the duodenum into the stomach. With vomiting, there is a strong contraction of the diaphragm and muscles of the anterior abdominal wall, holding the breath and a sharp release of the contents of the stomach into the esophagus and further into the oral cavity. This may be accompanied by increased salivation, sweating, weakness, dizziness.

Specific centers in the brain are responsible for the occurrence of nausea and vomiting, which receive information from the organs of the gastrointestinal tract, vestibular apparatus, other parts of the brain, kidneys, and also react to the chemical composition of the blood, including toxins, drugs, metabolic products. These centers trigger and control the activity of the muscles involved in nausea and vomiting.

Causes of nausea and vomiting may be as follows.

• Irritation of the gastric mucosa. In this case, nausea and vomiting are protective reactions of the body aimed at eliminating the damaging agent.
• Intestinal infections – rotavirus, salmonellosis, botulism, dysentery, etc. – in addition to nausea and vomiting, are accompanied by pain in the abdomen, fever. The most common infection is rotavirus. It is especially common among children attending kindergartens and nurseries, and occurs with nausea, vomiting, diarrhea, which usually lasts 1-2 days. After the disease, immunity is formed.
• Food poisoning. In this case, vomiting occurs within a few hours after eating.
• Gastric ulcer – damage to a section of the gastric mucosa due to the action of gastric juice. May be accompanied by belching, heartburn, abdominal pain.
• Gastroesophageal reflux disease is a chronic disease in which there is a regular reflux of stomach contents into the esophagus with damage to the mucous membrane of the esophagus by acidic gastric juice.
• Irritation of the stomach by other substances: alcohol, nicotine, aspirin.
• Effects on the central nervous system and vestibular apparatus. In this case, nausea and vomiting are caused by irritation of certain centers of the brain.
• An increase in intracranial pressure in brain injuries, tumors, infections (meningitis, encephalitis) may be accompanied by nausea and vomiting.
• Stimulation of the vestibular apparatus. It includes labyrinthitis (inflammation of the inner ear), motion sickness in transport, and other diseases and conditions in which excessive irritation of the balance organ occurs.
• Headache, especially in migraine. Migraine is a neurological disease characterized by severe headache, usually on one side, which may be exacerbated by bright lights or loud noises and accompanied by nausea and vomiting.
• Sunstroke. A condition that occurs when the head is exposed to the sun for a long time. Often found in children. May be accompanied by lethargy, weakness, nausea, vomiting, pallor, disorientation, loss of consciousness.
• Diseases of other organs – diabetes mellitus, urolithiasis, hepatitis, pancreatitis, certain malignant neoplasms, mental illness (depression, anorexia, bulimia) and other diseases.
• Medicinal products used in the treatment of oncological diseases, radiation therapy.
• Pregnancy (first trimester).
• In children under one year old, vomiting may be a sign of pyloric stenosis, intestinal intussusception, and often accompanies viral diseases (influenza, SARS). Pyloric stenosis is a narrowing or complete obstruction of the opening between the stomach and the duodenum. Intestinal intussusception is a condition in which a segment of the intestine is embedded in the lumen of an adjacent section of the intestine, which leads to the development of intestinal obstruction.

In adults, the most common causes of vomiting and nausea are intestinal infections, food poisoning, motion sickness; in children, intestinal infections, food poisoning, overeating, as well as a severe cough and any illness with a high fever.

Who is at risk?

• Preschoolers.
• Pregnant.
• Undergoing anticancer therapy.
• People with chronic diseases of the digestive system.
• People with mental illness.

Diagnosis

When determining the cause of nausea and vomiting, their duration, the time of their occurrence, the presence of signs of other diseases and conditions are important. Laboratory and instrumental studies are also important.

Laboratory diagnostics

• Complete blood count. An increase in white blood cells may indicate an infection as a possible cause of nausea and vomiting. An increase in the number of red blood cells indicates thickening of the blood due to dehydration.
• ESR. Erythrocyte sedimentation rate. Normally, red blood cells repel each other. With inflammation, the protein composition of the blood changes, electrolytes stick together more easily, and the rate of their sedimentation increases. Thus, an increase in ESR may indicate infection or chronic inflammation as a possible cause of nausea and vomiting.
• Blood electrolytes
• Potassium and sodium in blood serum. They participate in the transmission of a nerve impulse, muscle contraction, maintaining the acid-base balance of the blood. A decrease in serum potassium and sodium levels may indicate blood clotting and dehydration. Sodium levels can increase with kidney disease, adrenal dysfunction.
• Serum calcium. Calcium is involved in the formation of bone tissue, the conduction of a nerve impulse, and the work of some enzymes. A change in its level is a sign of diseases of the kidneys, thyroid gland, parathyroid glands, and some neoplasms.
• Serum glucose. Glucose is the main source of energy in the body. An increase in its concentration is characteristic of diabetes mellitus. A significant increase in its level may indicate diabetic ketoacidosis, a severe, life-threatening condition that develops with a lack of insulin. Without insulin, the body’s cells cannot use glucose for energy. As a result, the body begins to use fats, the breakdown of which produces toxic substances – ketones. Thus, the level of glucose and ketones in the blood rises. Diabetic ketoacidosis can lead to coma or even death if left untreated.
• Total amylase in serum. This is an enzyme that is produced in the pancreas and salivary glands. Essential for the digestion of carbohydrates. An increase in the level of amylase may indicate a pathological process in the pancreas.
• Lipase. An enzyme produced in the pancreas that is involved in the digestion of fats. An elevated lipase concentration is the most specific sign of pancreatic damage.
• β-subunit of human chorionic gonadotropin (beta-hCG) is a hormone that is produced by the membrane of the embryo and is involved in maintaining pregnancy. A blood test for beta-hCG is used to diagnose pregnancy. Home pregnancy tests are also based on determining its amount in the urine, however, determining its level in the blood is more reliable and can detect pregnancy already on the 6-8th day after fertilization.
• Urinalysis with microscopy. Dark, concentrated urine can be a sign of dehydration.
• Sowing feces for flora. Used for suspected intestinal infection.

Other tests

• Ultrasound examination (ultrasound), X-ray of the abdominal organs. They are used to assess the state of internal organs and identify the cause of nausea and vomiting.
• X-ray, computed tomography (CT), magnetic resonance imaging (MRI) of the skull. It is used to diagnose injuries, diseases of the brain.
• Endoscopic examination of the gastrointestinal tract. This is an examination of the digestive organs with the help of an endoscope – a special device in the form of a tube equipped with an optical system. During endoscopy, you can take a sample of tissue from the wall of the digestive tract for subsequent microscopic examination.
• Lumbar puncture for suspected diseases of the central nervous system. This is taking a sample of the fluid around the spinal cord. It is carried out after anesthesia. For research, a needle is used, which is inserted between the second and third or third and fourth lumbar vertebrae. The patient at this time sits or lies on his side, the back is maximally bent.
• Audiometry and electronystagmography. It is used to diagnose diseases of the vestibular apparatus. Audiometry is a test performed by an audiologist to determine hearing acuity. To do this, use a special device audiometer. Electronystagmography is a method of recording involuntary movements of the eyeballs during head movements, temperature changes, which provides information about the state of the vestibular apparatus.
• Electroencephalography (EEG) is a study of the electrical activity of the brain using sensors that are placed on the head. It is carried out with suspicion of a neurological or mental pathology. This way evaluate the state of the brain, its response to stimuli.

Treatment

Treatment depends on the underlying cause of the nausea and vomiting. There are also ways to help reduce these symptoms and prevent dehydration:

• Drink slowly, in small sips;
• eat in small portions, do not mix cold and hot food, exclude fatty, spicy, sweet, fried foods;
• do not eat during an attack of nausea;
• Do not brush your teeth immediately after eating;
• Avoid physical activity immediately after meals.

In addition, there are antiemetic drugs, but they should only be used as prescribed by a doctor after determining the cause of unpleasant symptoms.

Prevention

• Eating only fresh, properly processed foods.
• Proper diet, especially in diseases of the gastrointestinal tract.

Recommended tests

• Complete blood count
• Erythrocyte sedimentation rate (ESR)
• Serum potassium
• Serum sodium
• Serum calcium
• Total amylase in serum
• Lipase
• Serum glucose
• Beta subunit of human chorionic gonadotropin (beta hCG)
• Urinalysis with microscopy
• Daily urine potassium
• Daily urine calcium
• Fecal culture for pathogenic flora (disease group and typhoid-paratyphoid group)
• Cytological examination of the material obtained during endoscopy (EGD, bronchoscopy, laryngoscopy, cystoscopy, sigmoidoscopy, colonoscopy)
• Cytological examination of punctates, scrapings of other organs and tissues

when is it really dangerous? What to do with bouts of vomiting? When should you see a doctor for vomiting?

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Vomiting is a reflex eruption through the mouth of the contents of the stomach, and sometimes the duodenum.

Vomiting

The gag reflex is quite complex – it involves various muscle groups. It is controlled by the vomiting center located in the brain stem. By its very nature, vomiting is a mechanism by which the body defends itself against poisoning. Normally, vomiting is a reaction to the ingestion of toxic substances into the gastrointestinal tract or simply something that cannot be digested – for example, too fatty foods. Therefore, after an attack of vomiting, a person often feels relieved: the body has cleansed itself.

However, the intoxication that caused vomiting may have an internal source, that is, be the result of any pathology or disease. It is also possible that the irritation of the nervous system, leading to vomiting spasms, is not related to the state of the stomach at all. This makes one perceive vomiting as a very serious, and even formidable symptom. An attack of vomiting is almost always a sufficient reason to see a doctor. In case of recurring attacks, you should definitely consult a doctor!

Causes of vomiting

In most cases, vomiting is due to irritation of the receptors of the stomach or, in medical terms, has a visceral origin. The cause is most often acute or chronic diseases of the stomach itself (acute food poisoning, gastritis, stomach ulcers, food allergies). Also, the receptors of the stomach can also respond to diseases of other organs – the gallbladder, uterus, heart (vomiting is included in the complex of possible symptoms of myocardial infarction).

Vomiting can also be of central origin, that is, caused by pathologies of the central nervous system (brain), such as meningitis, encephalitis, trauma, and brain tumors. Quite often, vomiting is observed with migraines. Problems in the inner ear can also lead to vomiting (in which case, vomiting may be accompanied by dizziness). With excessive irritation of the receptors of the inner ear (during motion sickness), even a healthy person can vomit, especially if the vestibular apparatus is not trained. Sometimes vomiting is caused by an emotional disorder (stress) or is a reaction to something that causes extreme disgust (conditioned reflex vomiting).

Irritation of the vomiting center can be caused by toxic substances carried by the blood stream ( hematogenous toxic vomiting). Toxic substances can enter the body from the outside (for example, chlorine or carbon monoxide – by inhalation), or can be produced in the body itself – as a result of impaired liver or kidney function.

Vomiting and other symptoms

Usually vomiting is preceded by nausea, because, in fact, vomiting is the resolution of nausea, its logical conclusion. The fact that nausea turned into vomiting indicates the severity of the pathological process. Vomiting spasms can be observed against the background of elevated temperature, accompanied by diarrhea. In the vomit, in addition to food debris, gastric juice and mucus, bile, blood, and pus may be present.

Repeated, periodically recurring and indomitable vomiting exhausts and dehydrates the body, leads to a violation of mineral metabolism and acid-base balance.

Diarrhea and vomiting

Vomiting and fever

When vomiting scares

Any bout of vomiting is a very unpleasant experience. Even if a person experiences relief with the resolution of an attack, vomiting itself is perceived as an extraordinary event, which should not normally be. The shock of the body, domestic and social inconvenience – all this makes vomiting a process of a different order compared to other reflex actions, such as coughing or sneezing. We always react sharply to vomiting (we do not leave it unattended), and rightly so.

However, in some cases, vomiting worries us especially strongly. Such is vomiting of bile , vomiting of blood . Parents are worried about cases of vomiting in a child . Quite often, vomiting is observed during pregnancy , attracting increased attention.

These cases should be mentioned separately:

Vomiting of bile

Vomiting blood

Vomiting during pregnancy

Child vomiting

What to do if you’re vomiting

What to do if you’re vomiting

Because anyone can experience vomiting, it’s helpful to know how to prevent vomiting, what to do during and immediately after an attack, and when to see a doctor.

Nausea is a precursor to vomiting. If you feel sick, try opening a window (increase the oxygen supply), drinking some sweetened liquid (this will calm the stomach), sitting or lying down (physical activity increases nausea and vomiting). You can dissolve a tablet of validol. If you get sick on the road, take candy with you and dissolve on the way. This will help prevent vomiting.

What to do when vomiting

During an attack, it is important to exclude the ingress of vomit into the respiratory tract. The patient during vomiting should never lie on his back. Do not leave young children unsupervised if they may vomit. An elderly or weakened person must be helped to turn on his side, head to the edge of the bed, put a pelvis in front of him.

What to do after vomiting

After an attack, rinse your mouth with cold water. If the patient himself cannot do this, it is necessary to moisten a piece of gauze in a soda solution and wipe his mouth.

Immediately after the attack, you can drink only a few sips of water, and then if there was no blood in the vomit. You can drink properly only after 2 hours, and eat only 6-8 hours after the attack. Food should be dietary, sparing; best of all – porridge on the water, rice, low-fat soup.

With repeated attacks of vomiting, dehydration of the body is possible. Therefore, it is necessary to drink a special solution that restores the water-electrolyte and acid-base balance.

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When should you see a doctor if you vomit?

Vomiting is in many cases a sign that the body is experiencing serious problems and needs to be cleansed, and therefore, most likely, in treatment. If the disease is accompanied by vomiting, this usually indicates that the disease is quite severe.

If the attack of vomiting was one-time and there is reason to believe that it was caused by overeating, motion sickness, alcohol poisoning or stress, there is no direct need to see a doctor. In all other cases, a doctor’s consultation is necessary. Especially if the attacks are repeated for two days or more, as well as in the presence of diabetes or other chronic diseases.

Sometimes emergency care is required for vomiting. You need to call an ambulance if:

• vomiting accompanied by persistent or severe abdominal pain;
• there are repeated bouts of vomiting after a head injury;
• along with vomiting there is dehydration, dry mouth, increased urination;
• with deterioration of mental and functional activity in the elderly;
• there is blood in the vomit (for example, impurities in the form of “coffee grounds”).

Which doctor should I contact if I vomit?

Complaints of nausea and vomiting are usually addressed to a gastroenterologist or general practitioner (general practitioner, family doctor or pediatrician). In case of nausea and vomiting during pregnancy, you should contact your gynecologist.