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 brainstem that expels stomach contents.
Common causes
- Stomach virus and food poisoning.
- Motion sickness.
- Pregnancy.
- Migraine.
- Medicines, chemotherapy and alcohol.
- Gallbladder, pancreas or appendix problems.
- Heat, severe pain, strong smells.
Care
Rest, sip clear fluids, try ginger, restart with bland foods.
Dehydration signs
Dark urine, dizziness and dry mouth.
Get urgent care for
Blood, severe belly pain, head injury, stiff neck, confusion, or vomiting for over 24 hours.
Children
Use oral rehydration solution and call a pediatrician early.
What it is
Throwing up, or vomiting, is a reflex that forcefully empties the stomach through the mouth. The brainstem’s vomiting center starts it in response to signals from the gut, the inner ear, the brain or chemicals in the blood. Muscles of the diaphragm and abdomen contract while the esophageal sphincter relaxes.
Common causes
- Viral gastroenteritis (norovirus, rotavirus), which causes 19 to 21 million cases of illness a year in the US.
- Food poisoning: bacteria such as Staphylococcus aureus cause vomiting within 1 to 6 hours.
- Pregnancy, with nausea and vomiting in up to 80% of pregnancies.
- Motion sickness.
- Migraines.
- Medication and chemotherapy.
- Alcohol, overeating and spicy foods.
- Gallstones, appendicitis, pancreatitis and bowel obstruction.
- Concussion and meningitis.
- Stress, anxiety and bulimia.
Care
- Wait 30 to 60 minutes after vomiting, then sip small amounts of clear fluid, such as water or an electrolyte drink, every 5 to 10 minutes.
- Increase gradually and add bland foods when you feel better: bananas, rice, applesauce and toast.
- Avoid dairy, alcohol, caffeine and fatty foods for 24 to 48 hours.
- Rest and avoid strong smells.
- Over the counter options such as bismuth subsalicylate or emetrol may help adults. Do not give aspirin products to children.
Dehydration signs
Dark urine, thirst, dry mouth, dizziness, a fast heart rate, and in babies, a sunken soft spot and no wet diapers for over 6 to 8 hours.
Get urgent care for
Vomiting blood or material that looks like coffee grounds, severe belly pain, a stiff neck, severe headache, confusion, chest pain, signs of dehydration, vomiting that lasts more than 24 hours in adults, or after head injury.
Children
Call a pediatrician if a baby under 6 months vomits repeatedly, or if the child has green vomit, a high fever, is hard to wake or cannot keep fluids down. Offer oral rehydration solutions in small spoonfuls. Most vomiting in children from viruses resolves within 24 to 48 hours.
Mechanism and typical duration
Throwing up is controlled by the vomiting center in the brainstem, which is triggered by signals from the gut, inner ear and brain. Stomach viruses like norovirus cause about 19 to 21 million illnesses in the US each year, and symptoms usually last 1 to 3 days. Bacterial food poisoning from Salmonella, Campylobacter or E. coli causes about 48 million illnesses per year in the US, per CDC estimates. Other triggers include migraine, motion sickness, pregnancy, medicines, alcohol, gallbladder disease, appendicitis, concussion and intense emotion. Wait 30 to 60 minutes after the last vomit before sipping clear liquids, then use an oral rehydration solution in small amounts. Call a doctor for blood in vomit, green vomit, a severe headache, a stiff neck, or signs of dehydration such as dark urine, dizziness and no urination for 8 hours. In infants, vomiting with fever or a swollen belly needs urgent care.
Based on data from the CDC and the Mayo Clinic
