Repeated vomiting can be caused by a stomach virus, food poisoning, migraine, or pregnancy. Get urgent care for blood, severe pain, or dehydration.
Common causes
- Stomach virus (gastroenteritis).
- Food poisoning.
- Migraine.
- Pregnancy (morning sickness) and hyperemesis.
- Medications and alcohol.
- Gallbladder or pancreas disease.
- Cyclic vomiting syndrome.
- Acid reflux.
Care
Rest, sip clear fluids, try ginger and restart with bland foods.
Get urgent care for
Blood in vomit (red or coffee grounds), severe abdominal pain, signs of dehydration, head injury, stiff neck, confusion, or vomiting over 24 hours.
Children
Rehydrate with oral rehydration solution and call the pediatrician early.
Pregnancy
Call your provider.
Why the body vomits
Vomiting is a reflex controlled by the brainstem vomiting center, triggered by signals from the stomach and intestines, the inner ear, toxins in the blood, or the brain. It protects the body from poisons and forces out stomach contents. Nausea often comes first.
Common causes
- Viral gastroenteritis (stomach flu), the most common cause. Norovirus alone causes about 19 to 21 million illnesses a year in the US.
- Food poisoning, which starts within hours of eating.
- Motion sickness and vertigo.
- Pregnancy, with morning sickness affecting up to 70% to 80% of pregnancies. Hyperemesis gravidarum is severe and affects 1% to 3%.
- Migraine, medicine side effects, chemotherapy and anesthesia.
- Gastritis, ulcers, gastroparesis and acid reflux.
- Gallstones, appendicitis, pancreatitis and bowel obstruction.
- Head injury, concussion and meningitis.
- Cyclic vomiting syndrome, with repeated episodes.
- Cannabinoid hyperemesis syndrome in heavy cannabis users.
- Eating disorders, anxiety and stress.
Care at home
- Rest the stomach for an hour or so after vomiting, then take sips of water or oral rehydration solution, 1 tablespoon every 5 minutes.
- Gradually add bland foods like crackers, toast and rice when you can keep fluids down.
- Ginger, in tea or capsules, can help with nausea.
- Avoid strong smells, greasy and spicy food and alcohol.
- Wash hands well to prevent spreading infections.
Get urgent care for
Vomit with blood or that looks like coffee grounds, green bile, severe abdominal pain, stiff neck with fever, severe headache, confusion, chest pain, signs of dehydration, vomiting more than 24 hours in adults, or after a head injury.
Children
Children dehydrate quickly. Call the pediatrician if a baby under 3 months has vomiting with fever, vomiting lasts longer than 12 hours in infants or 24 hours in older children, there is no urination for 8 hours, or the child is lethargic.
Pregnancy
Eat small, frequent meals, take vitamin B6 (10 to 25 milligrams) with doxylamine as advised by a doctor, and contact a provider if you cannot keep any food or fluid down.
Triggers of the vomiting reflex
Vomiting is coordinated by the vomiting center in the brainstem, receiving signals from the gut, inner ear, brain and chemoreceptor trigger zone. Causes include stomach viruses, food poisoning, medications, motion sickness, migraine, pregnancy, alcohol, and cyclic vomiting syndrome. Persistent vomiting for more than 24 hours in adults, or 12 hours in infants, risks dehydration. Ondansetron is a prescription antiemetic used in emergency departments. Start with small sips of clear fluids, 1 to 2 teaspoons every 5 minutes, then advance to bland foods. Seek care for blood in vomit, severe headache, stiff neck, chest pain or signs of dehydration.
Based on data from the Mayo Clinic and the American Academy of Pediatrics
