Vomiting

Is this your symptom?

• Vomiting (throwing up) stomach contents
• It's normal for nausea (upset stomach) to come before each bout of vomiting

Causes of Vomiting

• Viral Gastritis. Infection from a stomach virus is the most common cause. Also called stomach flu. A common cause is the Rotavirus. The illness starts with vomiting. Watery, loose stools may follow within 12-24 hours.
• Food Poisoning. This causes rapid vomiting within hours after eating the bad food. Diarrhea may follow. Caused by toxins from germs growing in foods that were left out too long. An example is Staph toxin in egg salad.
• Medicines. Many meds (prescribed, over-the-counter, or recreational) can cause nausea and/or vomiting. Check the package instructions. If you are not sure, speak to a pharmacist or ask your doctor for advice. Chemotherapy can cause severe nausea and vomiting. Your doctor may prescribe anti-emetic meds to help reduce the vomiting.
• Alcohol. Drinking too much alcohol can cause vomiting.
• Food Allergy. Vomiting can be the only symptom of a food reaction. The vomiting comes on quickly after eating the food. Common foods are peanuts, tree nuts, fish and shellfish (such as shrimp).
• Motion Sickness. Vomiting and dizziness can be triggered by motion. Car travel, sea sickness or fun-park ride sickness are the most common types. It is strongly genetic.
• Migraine Headaches. Vomiting often happens with migraine headaches.
• Raised Pressure in the Brain can cause vomiting. This could result from a head injury; vomiting may happen at the time of the injury or days or weeks afterwards. It is a serious symptom and could mean there has been damage to the brain or bleeding inside the skull. Brain tumors and meningitis can also cause the pressure in the brain to increase.
• Liver Disease. Hepatitis A and B and liver cirrhosis can all cause nausea and vomiting. There may be other symptoms such as yellow skin and yellow in the whites of the eyes.
• Pregnancy. See Morning Sickness care guide.
• Ear Problems. Infection or problems in the inner ear that affect balance can cause dizziness, nausea and/or vomiting.

Serious Causes

• Vomiting alone (without diarrhea) should stop within about 24 hours. If it lasts more than 24 hours, you must think about more serious causes. Examples are appendicitis, a kidney or bladder infection, diabetes, blockage of the bowel and head injury.
• Vomiting Blood (serious) can be caused by stomach ulcers or by a rupture of veins at the entrance to the stomach. The blood may look brown, dark red or bright red. Bright red blood means that the bleeding is active (happening now). Call 911 if you are vomiting large amounts of blood (life-threatening). If you have been vomiting with force, it can sometimes cause small tears in the lining of your esophagus. You may see just a streak of bright red blood. It is best to get checked out if you vomit any amount of blood.
• Cyclic Vomiting is the most common cause of recurrent attacks of vomiting. Attacks have a sudden onset and offset.
• Stomach Problems. These include stomach ulcers and GERD (gastroesophageal reflux disease). GERD is when acid flows up the esophagus from the stomach.
• Diabetes. If you have diabetes, vomiting should not be ignored. It can mean your diabetes is out of control. Or it can make your diabetes hard to manage. Contact your doctor if you start to vomit.
• Addison's Disease and Hypercalcemia(high calcium levels) are much less common than diabetes, but can also have symptoms of nausea and vomiting.

Vomiting Scale

• Mild: 1 - 2 times/day
• Moderate: 3 - 7 times/day
• Severe: vomits everything or nearly everything or 8 or more times/day
• Severity relates even more to how long the vomiting lasts. At the start of the illness, it's common to vomit everything. This can last for 3 or 4 hours and then occur less often.
• The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
• The elderly and people with chronic disease are at the greatest risk for dehydration.

Dehydration: How to Tell

• The main risk of vomiting is dehydration. Dehydration means the body has lost too much water.
• Vomiting along with watery diarrhea is the most common cause of dehydration.
• Dehydration is a reason to see a doctor right away.
• You may have dehydration if not drinking much fluid and:
  • Urine is dark yellow and you are not passing urine as often as you normally would.
  • Inside of the mouth and tongue are very dry.
  • Slow blood refill test: longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.
  • If you have severe dehydration, you may be too weak to stand. You can also be very dizzy when trying to stand.