throwing up, emesis
Vomiting is when the stomach contents are ejected through the mouth.
What is going on in the body?
Most people have vomited at least once in their lives. Though unpleasant, vomiting is often the body's way of trying to get rid of harmful toxins. There are many different causes of vomiting.
What are the signs and symptoms of the condition?
The doctor often wants to know several things when a person is vomiting, including:
The doctor may ask other questions, which can help narrow the list of possible causes.
- when the vomiting started
- what the vomited material looks like
- how many times a person has vomited
- whether any friends or close family members have been vomiting
- whether or not the person has any abdominal distress or chest pain
- whether or not the person has a fever or is sick in any other way
- whether the person has a decreased appetite, which does not always happen with vomiting
- what the person was doing on the day he or she started vomiting
- any other symptoms, such as weight loss, dark-coloured stools, history of stomach problems or diabetes, or other symptoms
What are the causes and risks of the condition?
Any illness can cause vomiting, especially in infants. For instance, ear infections are a common cause of vomiting in infants. The flu can also cause vomiting. Other causes include:
Other causes are also possible. Sometimes, no cause can be found.
- stomach or intestinal infections, such as food poisoning or gastroenteritis
- peptic ulcers or gastro-oesophageal reflux disease
- inflammation in or around the gut, such as appendicitis, pancreatitis, hepatitis, or gastritis
- blockage in the bowels, such as pyloric stenosis or duodenal atresia in infants, or small or large bowel obstruction at any age
- food allergies or lactose intolerance
- toxins or medications, such as alcohol, many antibiotics, or chemotherapy in cancer patients
- kidney failure, such as acute renal failure
- heart attack
- pregnancy, which often causes morning sickness
- tumours or cancer, which may be in the stomach, intestines, or in other parts of the body
- increased pressure inside the skull, also called increased intracranial pressure
- certain types of uncontrolled diabetes
- extreme anxiety or a sense of disgust, such as from a foul odour
- extreme overexertion or exercise
- seasickness or motion sickness
- migraine headaches
- bulimia nervosa, an eating disorder with self-induced vomiting
What can be done to prevent the condition?
Prevention depends on the cause. For instance, avoiding alcohol can prevent vomiting due to alcohol. Avoiding extreme exercise can prevent vomiting due to exercise. In most settings, vomiting cannot be avoided, but can often be treated.
How is the condition diagnosed?
First, the doctor will take the person's health history and do a physical examination. This may be all that is needed to figure out the cause. In other cases, further testing must be done. Which tests are ordered depends on the suspected condition. For instance, blood tests can diagnose hepatitis, pancreatitis, and other conditions. An x-ray of the belly, done with or without a special dye, may show an ulcer or bowel blockage. If cancer is suspected, a special x-ray test, such as an abdominal CT scan, may be ordered. Other tests are also possible.
What are the long-term effects of the condition?
Prolonged vomiting can lead to dehydration and salt imbalances. Most other long-term effects are related to the cause. For instance, food poisoning usually goes away within 48 hours and causes no long-term effects. On the other hand, cancer may result in death.
What are the risks to others?
Vomiting itself is not contagious and poses no risk to others. However, if the cause is an infection, the infection may be contagious.
What are the treatments for the condition?
Medication to prevent nausea and vomiting, such as proclorperazine and metoclopramide, may be used. Fluids can be given through an IV in the vein if a person is dehydrated and can't keep anything in his or her stomach. If the cause is a viral infection or food poisoning, this may be all the treatment that is given.
Other treatments are directed at the cause. For instance, drugs such as ranitidine or omeprazole are often given for gastro-oesophageal reflux or peptic ulcers. Cancer may require surgery, chemotherapy, or radiation therapy. People with kidney failure may need to go on Dialysis or get a kidney transplant.
What are the side effects of the treatments?
All medications have possible side effects, including allergic reactions, stomach upset, or headache. Specific side effects depend on the medications used. Surgery carries a risk of infection, bleeding, or death. dialysis requires surgery first, and may result in infection or serious salt imbalances.
What happens after treatment for the condition?
This depends on the cause. For instance, morning sickness from pregnancy often goes away within a few months. No further treatment may be needed in this case. People with chronic renal failure or cancer, however, may need monitoring and treatment for the rest of their lives.
How is the condition monitored?
The most important thing to watch for with vomiting is dehydration, especially in children. Other monitoring depends on the cause of the vomiting. For instance, people with bulimia may need regular counselling and therapy.
Author: Adam Brochert, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 12/06/2005
Potential conflict of interest information for reviewers available on request