You feel sick and your stomach is clenching in pain. Next thing you know you’re bent over the toilet bowl. Vomiting is never comfortable. Read on to learn more about this common condition.
What is vomiting?
When you vomit, your stomach contents are uncontrollably expelled through the mouth. It is your body’s response to a contaminated substance so you can get rid of it to protect your gut and prevent possible harm. Nausea is a symptom also usually associated with vomiting.
Occurring in both children and adults, vomiting is not a disease in itself and is not something harmful or to worry about. One thing to watch out for though is dehydration but symptoms usually pass within 2-3 days. That being said, it can sometimes be a symptom of an underlying illness.
A number of factors can make you vomit. Most of the time it is due to gastroenteritis (a viral infection of the stomach), which is contagious. Remember to stay away from school or work until you’ve gone 24 hours without vomiting.
The most common causes of vomiting
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
– 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
– Drinking too much alcohol
– 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
– Noxious factors, e.g. certain smells, stress and pain
– Head injuries
– Electrolyte and hormonal imbalances
When to see a doctor
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 colour in your vomit
– rectal bleeding or blood in stool
– smell foul or fecal odour 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 a 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
How to treat vomiting
Treatment will depend on what the underlying cause is. This is determined by taking a history examination and doing some tests.
For mild case, 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.
What you can do to feel better
– 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.
You can prevent vomiting
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.
Dr. Lily Wong 黃淑婷醫生 is a family practitioner at The London Medical Clinic. She is both a registered general practitioner and a pharmacist in the UK and HK. Having lived and worked as a general practitioner for many years in busy practices in London, she relocated to Hong Kong with her family a few years ago. Dr. Wong has also been appointed Honorary Assistant Professor in the Department of Family Medicine at Hong Kong University, for her teaching of medical students.