Vomiting is a reflex to expel stomach contents caused by infection, food poisoning, motion sickness, or pregnancy. Seek care if it is severe or prolonged.
What it is
Vomiting is a reflex controlled by the brain’s vomiting center that expels stomach contents.
Common causes
- Stomach virus and food poisoning.
- Motion sickness.
- Pregnancy.
- Migraine.
- Medicines, chemotherapy, alcohol.
- Gallbladder, pancreas or appendix problems.
- Heat or severe pain.
Care
Rest, sip clear fluids, ginger and gradually bland foods.
Dehydration signs
Dark urine, dizziness, dry mouth.
Get urgent care for
Blood, severe abdominal pain, head injury, stiff neck, confusion, vomiting for more than 24 hours or inability to keep fluids down.
Children
Use oral rehydration solution and call a pediatrician early.
What vomiting is
Vomiting is the forceful emptying of the stomach through the mouth. It is controlled by the vomiting center in the brainstem, which receives signals from the gut, inner ear, brain and bloodstream. It is a protective reflex to remove harmful substances. It is different from regurgitation, which is effortless.
Common causes
- Stomach flu (viral gastroenteritis), usually with diarrhea. Norovirus is the leading cause of vomiting and diarrhea illness in the US.
- Food poisoning, which starts a few hours after eating contaminated food.
- Motion sickness and vertigo.
- Pregnancy, in the first trimester.
- Migraines and medication side effects.
- Gastritis, ulcers and gallbladder disease.
- Appendicitis and intestinal blockage, with severe belly pain.
- Concussion or head injury.
- Too much alcohol.
- Anxiety and stress.
- Cyclic vomiting syndrome, with episodes repeating.
Care
- Stop eating solid food for a few hours, and sip clear fluids slowly, such as water, oral rehydration solution or broth. Try 1 tablespoon every 5 minutes.
- Avoid dairy, caffeine, alcohol, spicy and fatty foods until you are better.
- Restart with bland foods such as toast, rice, bananas and crackers.
- Ginger and peppermint tea can ease nausea.
- Rest, and wash hands often to avoid spreading illness.
- Anti-nausea medicine, like ondansetron, is available by prescription.
Dehydration signs
Dry mouth, little or dark urine, dizziness when standing, a fast heartbeat, sunken eyes, and in children, no tears and no wet diaper for 6 or more hours.
Get urgent care for
Blood in vomit or vomit that looks like coffee grounds, severe abdominal pain, severe headache and stiff neck, high fever, confusion, chest pain, vomiting lasting more than 24 hours, signs of dehydration, or vomiting after a head injury.
Children
Infants and young children can dehydrate quickly. Call the pediatrician for vomiting in a baby under 12 months, vomiting for more than 12 hours, green vomit, or if the child is unusually sleepy or limp.
Mechanism and typical duration
Vomiting is controlled by the vomiting center in the brainstem, which receives signals from the gut, the inner ear, the brain’s chemoreceptor trigger zone and higher brain areas. Viral gastroenteritis, such as norovirus, is the leading cause of vomiting outbreaks and causes about 19 to 21 million illnesses in the US each year, according to the CDC. Symptoms usually appear 12 to 48 hours after exposure and last 1 to 3 days. Food poisoning can start within 1 to 6 hours for toxins like Staphylococcus aureus. Other causes include pregnancy (morning sickness affects up to 70 percent of pregnant women), migraines, motion sickness, medicines, alcohol, and concussion. Sip small amounts of oral rehydration solution every few minutes, and avoid solid food until vomiting settles for several hours. Seek care for blood in vomit, severe headache with stiff neck, or inability to keep fluids down for 24 hours.
Based on data from the CDC and the Mayo Clinic
