Vomiting

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DEFINITION

• Vomiting is the forceful emptying (throwing up) of a large portion of the stomach's contents through the mouth.
• Nausea and abdominal discomfort usually precede each bout of vomiting.

General Information

• Common causes include:
  • Viral gastritis and gastrointestinal infections (Stomach Flu)
  • Vomiting in first trimester of pregnancy (Morning Sickness)
  • Overeating
  • Medication side effect
  • Food poisoning
• Less common causes include:
  • Bowel obstruction, appendicitis, gallbladder disease, peptic ulcer
  • Inner ear disorders (e.g. labyrinthitis, motion sickness).
  • Response to certain smells
  • Alcohol intoxication
• Maintaining good hydration is the cornerstone of treatment of healthy adults with a new onset of vomiting. In general, an adult who is alert, feels well, and who is not thirsty or dizzy is not dehydrated.

See More Appropriate Topic (instead of this one) If

• Any CHEST PAIN
• Headache is the main concern, then see HEADACHE
• Abdominal pain is the main concern, then see either ABDOMINAL PAIN, MALE or ABDOMINAL PAIN, FEMALE or ABDOMINAL PAIN, UPPER
• DIARRHEA is worse than the vomiting

WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

• Very weak (can't stand)

Call Your Doctor Now (night or day) If

• You feel weak or very sick
• Signs of dehydration (e.g. no urine in more than 12 hours, very dry mouth, very lightheaded, etc.)
• Vomiting blood or black (coffee grounds)
• Vomiting more than once and you
  • Are over 60 years of age OR
  • Have diabetes mellitus OR
  • Are bedridden (e.g. nursing home patient, stroke, chronic illness) OR
  • Have other risks (e.g. brain tumor, chemotherapy, inguinal hernia, recovering from surgery)
• Severe abdominal pain
• Constant abdominal pain for more than 2 hours
• Abdomen is more swollen than usual
• Fever of 103 F (39.4 C) or higher
• Recent abdominal or head injury (within 3 days)
• Severe headache
• Severe pain in one eye
• Taking any of the following medications: digoxin (Lanoxin), lithium, theophylline, phenytoin (Dilantin)

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think you need to be seen
• Fever present for more than 3 days
• Vomiting for more than 48 hours
• Vomiting a prescribed medication or recently started on a new medication

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Vomiting is a recurrent problem

Self Care at Home If

• Mild vomiting (possibly gastritis) and you don't think you need to be seen

HOME CARE ADVICE FOR MILD VOMITING

1. For Continuous Vomiting, Try Sleeping: Try to go to sleep. (Reason: sleep often empties the stomach and relieves the need to vomit.) When you awaken, resume drinking liquids. Water works best initially.
2. Clear Liquids: Try to sip small amounts (1 tablespoon) of liquid frequently (every 5 minutes) for 8 hours, rather than trying to drink a lot of liquid all at one time.
   • Sip water or a rehydration drink (e.g. Gatorade or Powerade)
   • Other options: 1/2 strength flat lemon-lime soda or ginger ale
   • After 4 hours without vomiting, increase the amount.
3. Solid Food:
   • You may begin eating bland foods after eight hours without vomiting. Start with saltine crackers, white bread, rice, mashed potatoes, cereal, applesauce etc.
   • After 48 hours on a bland diet, you may resume a normal diet.
4. Avoid Medicines: Discontinue all non-prescription medicines for 24 hours. (Reason: they may make vomiting worse.) Call if vomiting a prescription medicine.
5. Contagiousness: You can return to work or school after vomiting and fever are gone.
6. Expected Course: Vomiting from viral gastritis usually stops in 12 to 48 hours. If diarrhea is present, it usually continues for several days.
7. Call Your Doctor If:
   • Vomiting persists for 48 hours
   • Signs of dehydration occur
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.