Vomiting: All You Need to Know, Doctor-Reviewed

Babies and children

• Viral infections, especially gastroenteritis (stomach flu)
• Food poisoning
• Motion sickness
• Food allergy, milk intolerance
• Overeating or overfeeding
• Other infections, e.g. urinary tract infections, middle ear infections or meningitis
• Bowel obstruction, e.g.hernia and pyloric stenosis

Adults

• Bacterial or viral infections, especially gastroenteritis (stomach flu)
• Food poisoning
• Food intolerance, e.g. lactose intolerance
• Pregnancy, particularly during the first 3 months
• Motion sickness
• Cancer, chemotherapy and radiotherapy
• Medication, e.g. ibuprofen
• Overeating
• Drinking too much alcohol
• Migraines
• Intestinal diseases, e.g. Crohn’s disease, blockages such as hernia
• Other serious conditions, e.g. appendicitis, meningitis, kidney infection, gallbladder disease and brain tumors
• Gastroesophageal reflux disease (GERD) and ulcers
• Labyrinthitis
• Noxious factors, e.g. certain smells, stress and pain
• Head injuries
• Electrolyte and hormonal imbalances

You should get immediate medical attention if you vomit and:

• develop a sudden, severe headache, neck stiffness and a rash
• have a high fever
• feel confused, irritable or become less responsive
• are breathless or have a rapid pulse
• experience severe pain or cramps in the abdomen
• see blood (bright or brownish-red) or green color in your vomit
• rectal bleeding or blood in stool
• smell foul or fecal odor in your vomit
• believe you have eaten something poisonous

You should consult your doctor if you:

• have been vomiting for more than 24 hours (more than 2 or 3 hours for those under 6 years old)
• also have diarrhea for more than 24 hours
• vomit clear fluids
• are dehydrated, e.g. dry mouth, dark yellow urine, no urination for 6-8 hours, dizziness, weakness or no tears when crying
• also have diabetes, especially if you are on insulin
• have weakened immunity, e.g. from steroids or chemotherapy
• have lost much weight without a known reason
• vomit very often
• are pregnant or think you may be pregnant

Treatment will depend on what the underlying cause is. This is determined by taking a history examination and doing some tests.

For mild cases, some medications for vomiting are available over-the-counter. Antihistamines are commonly used, examples include promethazine, dimenhydrinate and meclizine hydrochloride. It is good to talk to your doctor or pharmacist before taking OTC medications and follow the instructions listed on the packages.

You can also get other medications from your doctor or buy them with a prescription at a pharmacy, such as metoclopramide and domperidone.

• Sip large amounts of clear fluids or suck on ice chips every 15 minutes for 3-4 hours. Drinking too much in one go could trigger more vomiting.
• Avoid acidic, sugary, milk, fizzy or alcoholic beverages and coffee as they can worsen the symptom.
• Do not eat solid foods until there is no more throwing up. Start with bland and easy-to-digest foods (the BRAT diet: bananas, rice, applesauce, dry toast and crackers).
• Avoid spicy, oily or fibrous food.
• Rest by lying on your stomach or on your side.
• Stop any medication until vomiting has passed. Some of them can upset the stomach, for example NSAIDs (e.g. ibuprofen, diclofenac, aspirin). Tell your doctor or pharmacist if you think vomiting is due to your medication.
• Use an oral rehydration solution to replace the lost fluids and electrolytes and to treat dehydration.
• Rinse your mouth with water to remove stomach acid from your mouth. Do not brush your teeth right away. This can damage your enamel.

Take notes! The following helps keep you away from vomiting:

• Maintain good personal hygiene to avoid germs.
• Eat meals in smaller portions and slowly.
• Avoid hot, spicy food and those that are hard to digest.
• Do not lay down or exercise immediately after meals.
• Do not drink excessive alcohol.
• Flush vomit from the toilet. Clean and disinfect the area afterwards.
• Avoid close contact with sick people, e.g. sharing food or eating utensils.

Vomiting often follows nausea. You can try these tips to prevent throwing up when you start to feel nauseated:

• Drink small amounts of clear sweetened (not acidic) liquids slowly.
• Sit down or lie in a propped up position.
• Do not take part in physical activities.
• Do not look out the side windows when in a moving vehicle. Distract yourself, e.g. listening to music.