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The forceful throwing up or discharge of the contents of the stomach and, at times, the proximal small intestine through the mouth is known as vomiting. It is a common symptom of various health conditions, many not pertaining to gastrointestinal problems.
A reaction to a particular activity or food may result in one-time vomiting, but vomiting caused by gastrointestinal problems or food poisoning can last up to a few days.
How Common Is Vomiting?
In population studies, around half of adults reported at least one episode of nausea and more than 30% reported an incident of vomiting in the past year. Nausea was more frequent among women than men. (1)
A study estimated that around 1.6% of consultations in a health care setting were for vomiting or nausea. (2)
Causes of Vomiting
Vomiting is generally a result of the following conditions:
1. Gastroenteritis
Gastroenteritis is a stomach and intestinal infection caused by viruses, bacteria, or parasites which triggers vomiting, inflammation, and various other symptoms of differing severity.
2. Food poisoning
Leaving out food for too long can lead to toxin deposition by germs, which, upon consumption, causes rapid diarrhea and vomiting. For example, staph toxins develop quickly in egg salads.
3. Radiation therapy
Radiation therapy may cause vomiting and nausea, especially if it involves the liver, gastrointestinal tract, or brain. The chances of vomiting increase with the size of the area being treated and the dose of radiation.
4. Coughing
Violent coughing can often induce vomiting in children, especially if they have reflux.
5. Motion sickness
Constant motion, such as during sea travel or amusement park rides, can cause dizziness and vomiting.
6. Migraine
It is common for children and adults with migraine problems to vomit during an attack.
7. Pregnancy
Morning sickness is a common symptom of pregnancy, especially between the 6th and 14th weeks.
8. Crohn’s disease
Crohn’s disease is an inflammatory bowel disease that causes vomiting as one of its symptoms.
9. Other causes
Some other health problems that can lead to vomiting include:
- Acute hepatitis
- Peptic ulcers
- Genitourinary problems (urinary tract infections, pyelonephritis)
- Drug use
- Cancer or tumor
- Metabolic or neurologic conditions
- Appendicitis
- Gallstones
- Kidney stones
- Vertigo
- Ear infections
- Accidental poison intake
10. Cyclic vomiting disorder
In this condition, the patient experiences severe vomiting every day at approximately the same time. This disorder is more common in children than in adults.
The triggers for cyclic vomiting differ from person to person and can be difficult to pin down. The most common ones include:
- Menstruation
- Emotional stress
- Infections
- Extreme excitement
Symptoms Associated With Vomiting
Because vomiting can be a result of various reasons, it is can be accompanied by various symptoms. Additionally, severe vomiting can cause several health problems. These include:
- Dehydration
- Reduced urination or dark urine
- Irritability
- Thirst
- Lack of appetite
- Weight loss
- Dry and dull skin
- Sleepiness
- Dry mouth
- Abdominal pain
- Dizziness
- Headache
Standard Medical Treatment for Vomiting
Various medical interventions are available to relieve vomiting.
1. Medications
Bismuth subsalicylate is the most common medicine used for vomiting which protects your stomach lining and helps manage ulcers, diarrhea, and upset stomach.
Other drugs used for vomiting include:
- Ondansetron
- Promethazine
- Diphenhydramine
- Dimenhydrinate (Dramamine)
- Meclizine (Bonine)
Some of these medicines prevent the signals induced by motion sickness from reaching your brain, therefore preventing nausea and vomiting. Your doctor will select the appropriate medicine for you depending on the cause of your vomiting.
2. Muscle relaxation with guided imagery
Progressive muscle relaxation (PMR) involves the alternate relaxation and contraction of the muscles in the body. Different muscle groups are targeted progressively, starting from the head to the feet, or vice versa.
3. Biofeedback
Biofeedback helps relieve anxiety and stress, therefore helping treat vomiting induced by muscle tension. This therapy involves the use of sensors to detect physiological changes such as temperature, pulse, brain wave pattern, and muscle tone.
Diagnosing Vomiting
To help the doctor determine the underlying cause of your vomiting, the following procedures and tests may be performed:
1. Medical history
The doctor will inquire about your previous health problems as well as those that run in your family to get insights into your present condition. The use of recreational drugs or cigarette smoking and other relevant factors will also be accounted for.
2. Physical examination
The physical examination includes checking for signs of dehydration, hypotension (including orthostatic hypotension), and jaundice. The doctor will also test your skin turgor and take a look at your mucous membranes.
3. Lab tests
The doctor may order various tests to determine problems in the gastrointestinal tract, including:
- Blood test: This test includes total blood count to detect infections or anemia, kidney function, and electrolyte panel tests to determine electrolyte imbalance and liver issues and albumin tests to assess your nutrient status.
- Pregnancy test: This may be needed for females of childbearing age.
- Gastric emptying study/scintigraphy: This procedure involves the consumption of bland meals such as eggs with a minute amount of radioactive material. Then, an external camera is used to scan the abdominal regions having the radioactive material.
- Gastroduodenal manometry: In this test, a catheter is inserted through the mouth to measure duodenal-jejunal pressure levels for 6 hours, first in a fasting state, and then after a meal. The comparative pressure readings help evaluate the effect of prokinetic agents.
- Wireless capsule gastrointestinal monitoring: In this video capsule endoscopy technique, a disposable capsule is ingested by the patient. The capsule transmits internal images of the gastrointestinal tract to a receiver worn by the patient.
- Esophageal manometry: This test records the pattern of esophageal muscle (or sphincter) contractions along with their pressure. Any discrepancy in the muscle’s strength or contractions can result in heartburn, pain, and swallowing difficulties.
4. X-ray
An abdominal X-ray can help visualize the liver, stomach, spleen, intestines, and diaphragm. This test is performed to detect the cause of vomiting, which could be kidney stones, blockage (obstruction) or hole in the intestine, a tumor, or severe constipation.
Vomiting vs. Nausea
People often use vomiting and nausea interchangeably. Although these terms may be related, they are not the same.
Vomiting involves a set of autonomic and motor responses that cause expulsion of the stomach contents, whereas nausea is only the discomforting, subjective feeling that you are likely to vomit.
Risk Factors for Vomiting
Vomiting is a common problem experienced by everyone, regardless of age or gender. However, the following factors can increase the risk of vomiting:
- Gender: Women are more prone to nausea and/or vomiting than men may be due to the hormonal changes in women.
- Alcohol and drug use: People who do not consume alcohol or prescription medications are not adapted to chemical alterations in the body, making them more prone to nausea and/or vomiting.
- Age: Nausea and/or vomiting is found to be more common among people younger than 30 years of age.
Complications Associated with Vomiting
If left untreated, frequent vomiting may result in:
- Dehydration (excessive loss of water, especially when vomiting is accompanied by diarrhea)
- Electrolyte changes
- Changes in mental status
- Appetite loss
- Torn esophagus
- Headaches
When to See a Doctor
You should visit a medical practitioner if you experience repetitive vomiting or the vomiting is accompanied by:
- Abdominal cramps or pain
- Fever
- Fatigue or faintness
- Blood in the vomit
- Blood or mucus in bowel movement
- Inability to consume fluids
- Abdominal swelling
- Dehydration (marked by dizziness, dry mouth, dark-colored urine)
- Confusion
Final Word
Occasional vomiting does not pose any health risk, but frequent or severe vomiting can lead to life-threatening conditions, such as aspiration pneumonia and dehydration.
If the condition persists despite preliminary self-care and rehydration therapy, seek medical evaluation to identify and treat the underlying cause.
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