Vomiting

DEFINITION

Vomiting is the forceful emptying (throwing up) of a large portion of the stomach's contents through the mouth
Nausea and abdominal discomfort usually precede each bout of vomiting

General Information

Common causes include:
- Viral gastritis and gastrointestinal infections (Stomach Flu)
- Vomiting in first trimester of pregnancy (Morning Sickness)
- Overeating
- Medication side effect
- Food poisoning
Less common causes include:
- Bowel obstruction, appendicitis, gallbladder disease, peptic ulcer
- Inner ear disorders (e.g., labyrinthitis, motion sickness).
- Response to certain smells
- Alcohol intoxication
Maintaining good hydration is the cornerstone of treatment of healthy adults with a new onset of vomiting. In general, an adult who is alert, feels well, and who is not thirsty or dizzy is not dehydrated.

See More Appropriate Topic (instead of this one) If

Any CHEST PAIN
Headache is the main concern, then see HEADACHE
Abdominal pain is the main concern, then see either ABDOMINAL PAIN, MALE or ABDOMINAL PAIN, FEMALE or ABDOMINAL PAIN, UPPER
DIARRHEA is worse than the vomiting

WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

Very weak (can't stand)

Call Your Doctor Now (night or day) If

You feel weak or very sick
Signs of dehydration (e.g., no urine in more than 12 hours, very dry mouth, very lightheaded, etc.)
Vomiting blood or black (coffee-grounds)
Vomiting more than once and you
- Are over 60 years of age OR
- Have diabetes mellitus OR
- Are bedridden (e.g., nursing home patient, stroke, chronic illness) OR
- Have other risks (e.g., brain tumor, chemotherapy, inguinal hernia, recovering from surgery)
Severe abdominal pain
Constant abdominal pain for more than 2 hours
Abdomen is more swollen than usual
Fever of 103° F (39.4° C) or higher
Recent abdominal or head injury (within 3 days)
Severe headache
Severe pain in one eye
Taking any of the following medications: digoxin (Lanoxin), lithium, theophylline, phenytoin (Dilantin)

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

You think you need to be seen
Fever present for more than 3 days
Vomiting for more than 48 hours
Vomiting a prescribed medication or recently started on a new medication

Call Your Doctor During Weekday Office Hours If

You have other questions or concerns
Vomiting is a recurrent problem

Self Care at Home If

Mild vomiting (possibly gastritis) and you don't think you need to be seen

HOME CARE ADVICE FOR MILD VOMITING

For Continuous Vomiting, Try Sleeping:
- Try to go to sleep (Reason: sleep often empties the stomach and relieves the need to vomit).
- When you awaken, resume drinking liquids. Water works best initially.
Clear Liquids: Try to sip small amounts (1 tablespoon) of liquid frequently (every 5 minutes) for 8 hours, rather than trying to drink a lot of liquid all at one time.
- Sip water or a rehydration drink (e.g., Gatorade or Powerade).
- Other options: 1/2 strength flat lemon-lime soda or ginger ale.
- After 4 hours without vomiting, increase the amount.
Solid Food:
- You may begin eating bland foods after eight hours without vomiting. Start with saltine crackers, white bread, rice, mashed potatoes, cereal, applesauce, etc.
- After 48 hours on a bland diet, you may resume a normal diet.
Avoid Medicines:
- Discontinue all non-prescription medicines for 24 hours (Reason: they may make vomiting worse).
- Call your doctor if vomiting a prescription medicine.
Contagiousness: You can return to work or school after vomiting and fever are gone.
Expected Course: Vomiting from viral gastritis usually stops in 12 to 48 hours. If diarrhea is present, it usually continues for several days.
Call Your Doctor If:
- Vomiting persists for 48 hours
- Signs of dehydration occur
- You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: David A. Thompson, M.D.

Last Reviewed: 9/21/2007

Last Revised: 3/21/2007

Content Set: Adult HouseCalls Online