What is vomiting?
Vomiting, also known as emesis and throwing up, is the forceful ejection of the stomach’s contents. Vomiting is a common symptom of a wide variety of mild to serious diseases, disorders and conditions. It may or may not occur with nausea.
Depending on the cause, vomiting can begin suddenly and disappear quickly, as in the case of alcohol intoxication. Vomiting may also recur over days, weeks or months, such as vomiting due to morning sickness or pancreatitis.
Vomiting causes include digestive system disorders, as well as disorders of other body systems.
Vomiting that is associated with head injury, vomiting blood, vomiting bile (a greenish-yellow substance), dizziness, weakness, or change in level of consciousness can be a symptom of a serious, potentially life-threatening condition. Call 911 for any of these symptoms.
What other symptoms might occur with vomiting?
Vomiting may occur with other symptoms depending on the underlying disease, disorder or condition. Symptoms that frequently affect the digestive tract may also involve other body systems.
Digestive symptoms that may occur along with vomiting
Vomiting may occur with other symptoms affecting the digestive tract including:
Other symptoms that may occur along with vomiting
Vomiting can also be caused by problems in body systems other than the digestive tract including:
Fever and chills
Referred shoulder pain
Serious symptoms that might indicate a life-threatening condition
In some cases, vomiting may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Get immediate help (call 911) for these symptoms:
Bloody or black stools
Change in level of consciousness
Chest pain or pressure
Confusion and disorientation
High fever (higher than 101°F)
Rapid pulse or rapid breathing
Severe abdominal pain
Severe dizziness and weakness
Vomiting blood or black material (resembling coffee grounds)
- Yellow skin and eyes (jaundice)
What causes vomiting?
Conditions known to cause vomiting include infection, poisoning, mental health illnesses, malignancy (cancer), inflammation, trauma, obstruction, and other abnormal processes within the digestive system, nervous system, reproductive system, cardiovascular system, or endocrine system. A part of the brain called the chemoreceptor trigger zone (CTZ) controls and coordinates the vomiting process, which is why conditions and certain drugs that affect the nervous system can induce vomiting.
Gastrointestinal causes of vomiting
Vomiting may arise from problems in the digestive tract including:
Gastroesophageal reflux disease (GERD)
Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
Overeating or eating a high-fat meal
Peptic ulcer and H. pylori infection
- Viral gastroenteritis (stomach flu), the most common cause of vomiting overall
Other causes of vomiting
Vomiting can also be caused by problems in body systems other than the digestive tract. Causes include:
Altitude sickness or motion sickness
Brain tumor or brain swelling
Cancer and chemotherapy medications
Exposure to smoke or toxic fumes or substances
Medication side effects
Pregnancy and morning sickness
- Vertigo and labyrinthitis
Life-threatening causes of vomiting
In some cases, vomiting may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Call your doctor or poison-control hotline (1-800-222-1222) immediately or take the person to an emergency care facility if you suspect poisoning or drug ingestion.
Life-threatening causes of vomiting include:
Bleeding peptic ulcer
Intestinal ischemia (loss of blood supply to the intestines)
Kidney or liver failure
Meningitis (infection or inflammation of the sac around the brain and spinal cord)
Uremia (buildup of urea and other toxins in the blood)
When should you see a doctor for vomiting?
In most cases, the cause of vomiting is not serious and it usually resolves with home treatment. However, there are times when seeing a doctor is best. See a doctor promptly when:
Unexplained weight loss accompanies vomiting episodes
Vomiting episodes occur on and off for more than a month
Vomiting has occurred three or more times in one day
Vomiting, as opposed to spitting up, occurs in a baby less than 2 months old
Vomiting lasts for more than 12 hours in infants, 24 hours in older children, and 48 hours in adults
Call 911 or go to your nearest emergency room for throwing up when:
You are vomiting blood, bile (a yellow-green vomitus), or coffee ground-like material. Any of these symptoms may signal a bleeding ulcer.
You have been unable to keep fluids down for 12 hours.
You have had a recent head injury or the vomiting could be due to a toxin or poison.
You have signs of dehydration, including excessive thirst, dark-colored urine, urinating less than normal, headache, skin that remains raised after pinching it, or dizziness, lightheadedness or fainting.
- Your child has signs of dehydration, including dry mouth and tongue, irritability, no tears with crying, no wet diapers for three hours, skin that stays tented when pinched, or sunken eyes cheeks, or soft spots.
How do doctors diagnose the cause of vomiting?
To diagnose the cause of vomiting, your doctor may ask you several questions including:
When did the vomiting start?
How long have you been vomiting? How often does it occur?
Have you been able to eat or drink in the last 12 hours?
Are you nauseated?
What, if anything, seems to make the vomiting better or worse?
Do you have any other symptoms, such as fever, diarrhea or headache?
Have you lost weight?
Have you recently traveled outside the country or been around anyone who is sick?
What other medical conditions do you have?
What medications do you take?
Your doctor will perform a physical exam, which may include feeling your abdomen. Your doctor will also look for signs of dehydration. Depending on what your doctor finds, testing may be necessary. This could include blood tests, urinalysis, or imaging exams of the abdomen, such as ultrasound or CT (computed tomography) scan. Women of childbearing age may need a pregnancy test.
It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.
How do you treat vomiting?
Vomiting treatment is not always necessary. The need for treatment will depend on the cause, the severity, and your comfort. Simple causes of vomiting, such as viral gastroenteritis (stomach flu), will resolve on their own with home remedies. If an underlying medical condition is responsible, treating it should help resolve the vomiting.
There are also medicines to treat vomiting. For motion sickness, over-the-counter antihistamines are often useful. Prescription medicines are available to treat more severe causes of vomiting, such as cancer chemotherapy.
Home remedies for vomiting
There are several home remedies to help manage vomiting and prevent it when nausea occurs. Strategies include:
Avoiding alcohol, caffeinated drinks, and spicy, fatty or fried foods
Avoiding strong odors, including cooking smells
Drinking frequent sips of clear, cold, sweet liquids, such as ginger ale and non-citrus juices. Popsicles and rehydration solutions are also options.
Eating small meals of cold or room temperature, bland foods, such as crackers, plain bread, rice, or chicken soup, slowly and frequently
Sitting or reclining instead of lying flat and avoiding physical activity
If your motion sickness causes you to vomit, talk with your doctor about ways to prevent it and manage it.
Alternative treatments for vomiting
Alternative and complementary treatments can help prevent and control nausea and vomiting. This is especially true for certain conditions, such as early pregnancy, postoperative nausea and vomiting, and cancer treatments. Many of these therapies do not use drugs at all, but focus on a mind-body connection instead. Alternative treatments include:
Biofeedback, in which you learn how to gain conscious control over physical processes
Relaxation techniques, such as breathing exercises, guided imagery, meditation, and progressive muscle relaxation
Supplements, including ginger and vitamin B6 (pyridoxine)
- Systematic desensitization, which teaches you how to reduce anxiety-related problems, such as nausea and vomiting
There are also essential oils and some herbs and plants that may help manage nausea and vomiting. Examples include ginger, peppermint, lemon and chamomile. Teas and aromatherapy with essential oils are generally safe, but talk with your doctor before using a supplement to treat nausea and vomiting.
What are the potential complications of vomiting?
Left untreated, vomiting can lead to serious complications, especially if the vomiting is severe, continues for days, or the underlying disease or condition is untreated or poorly managed. Complications include:
Anemia and shock caused by vomiting of blood
Aspiration of stomach contents into the airway and lungs
Dehydration due to a decreased desire to drink or ability to hold fluids
Mallory-Weiss tear (tear of the lower esophagus resulting in severe bleeding)
Poor nutrition due to a decreased desire to eat
- Tooth decay