Definition and Overview
Vomiting is a forceful ejaculation of food through the esophagus from the stomach. The food comes out of the mouth or, less commonly, nose. It can be both voluntary and involuntary, and is often seen as a symptom rather than a condition.
Many people tend to confuse nausea and vomiting since both tend to come together, but they are different. Nausea is the sensation of vomiting and it always precedes vomiting, but not all cases of nausea lead to expelling. In the same manner, vomiting doesn’t have to be accompanied by nausea.
Vomiting is also different from regurgitation. In the latter, the undigested food goes way back up and passes through the mouth or the nose. This means that the food hasn’t reached the stomach yet. Regurgitation is a common digestive process of animals.
Vomiting is seen as the body’s natural way to get rid of something. For example, if a person has eaten something big and it lodges itself in the throat or the esophagus, the instinct is to cough it up or vomit. It may also be a sign that something is wrong with the digestive system and may appear along with the other symptoms to indicate an existing disease.
To vomit doesn’t have to be necessarily harmful. It is, for instance, typical among pregnant women. Experts believe that the significant changes in hormones can lead to nausea or vomiting in the morning, also known as morning sickness. It’s also normal for babies during their first few days to vomit as their digestive system gets used to milk.
However, when it becomes prolonged or successive, or the condition worsens, it may lead to dehydration, which can put the vital organs in a life-threatening situation.
Causes of Condition
Below are the most common reasons why a person vomits:
Digestive problems – These can range from indigestion to stomach ulcers, ulcerative colitis, and gastroenteritis. It may also occur when a person has eaten spoiled food or has suffered from food poisoning, in which case vomiting is a way to get rid of the toxin in the body.
Ingestion of toxic substances – Induced vomiting is also another method of treating ingestion of toxic substances or chemicals such as alcohol. However, this requires medical attention as soon as possible.
Pregnancy – As mentioned, vomiting is a common occurrence among pregnant women. It normally happens during the first trimester (first three months) of pregnancy after which, nausea and vomiting start to subside and eventually stop. Although vomiting among pregnant women is not necessarily harmful, it becomes dangerous when they are diagnosed with hyperemesis gravidarum, which is described as persistent or prolonged vomiting and nausea. This is often accompanied by constipation, lightheadedness, and even fainting spells.
Movement – Some people can become sick when in motion such as riding a vehicle or a vessel (e.g., boat).
Medications – Some drugs are so strong they have significant side effects such as vomiting. A good example is chemotherapy drug.
Exhaustion – When a person is under a lot of physical stress and exhaustion, a part of the nervous system called the parasympathetic, which regulates the movements of involuntary muscles found in the digestive system, is activated. Exhaustion may happen due to long hours at work, extreme exercise, and even jet lag.
Other possible causes can include:
- Problem with the liver or kidney
- Appendicitis (inflammation of the appendix)
- Migraines or headaches
Vomiting is a symptom itself. It may occur on its own or along with other signs of a disease or a health problem. These other symptoms can be:
- Dizziness or lightheadedness
- Fainting spell
- Bloating or feeling full
- The feeling that food is going back up the throat
- Acidic taste in the mouth
- Problems in vision
- Abnormal sweating
- Rapid heart rate
- Unexplained weight loss
- Loss of appetite
- Excessive coughing
Vomiting usually isn’t treated as an emergency as it can stop within 24 hours from the time it began. However, it’s best to seek medical attention if vomiting hasn’t let up for the past 2 to 3 days, if the reason is life threatening such as food poisoning or ingestion of toxic substances, or if it becomes more difficult to drink water for at least a half day. The patient should also be brought to the hospital if vomiting is accompanied by extremely high fever, excessive sweating, significant pain, disorientation, or loss of certain body and mental functions. Diabetic patients should be careful when they experience vomiting as well since it can cause fluctuations in blood sugar.
Who to See and Treatments Available
Adult patients can see an internist while children must be brought to a pediatrician. Pregnant women, on the other hand, can go to their gynecologist for advice.
It’s important for the doctor to find out the cause of vomiting so the right treatment can be provided. This involves a thorough physical exam, assessment of the patient’s medical and family history, and the identification of other symptoms. Other tests such as urinalysis and complete blood count (CBC) must also be performed.
Depending on the doctor’s diagnosis, the treatment may include:
- Drinking of fluids to prevent dehydration. The fluids can also help flush out toxins from the body that may be causing nausea and vomiting.
- Complete bed rest or lying down
- Medications, such as those that can prevent motion sickness and digestive issues like indigestion
- Change of food or diet including BRAT (banana, rice, applesauce, toast)
- Less stressful activities
- Treatment of the condition causing vomiting such as surgery to remove any blockages in the intestine or tumor
- Low-impact exercises
- Intravenous fluid (IV) especially if the person cannot tolerate food, needs medication ASAP, or showing signs of dehydration
Vomiting may go away as soon as the treatment is provided. However, in some cases, it may take days before it officially stops. Meanwhile, since vomiting can appear with other symptoms, more than one treatment option may be carried out.
Malagelada J-R, Malagelada C. Nausea and vomiting. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 14.
Mcquaid K. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 134.