Causes of Vomiting

• Viral Gastritis. Infection from a stomach virus is the most common cause. Also called stomach flu. A common cause is the Rotavirus. The illness starts with vomiting. Watery, loose stools may follow within 12-24 hours.
• Food Poisoning. This causes rapid vomiting within hours after eating the bad food. Diarrhea may follow. Caused by toxins from germs growing in foods that were left out too long. An example is Staph toxin in egg salad.
• Medicines. Many meds (prescribed, over-the-counter, or recreational) can cause nausea and/or vomiting. Check the package instructions. If you are not sure, speak to a pharmacist or ask your doctor for advice. Chemotherapy can cause severe nausea and vomiting. Your doctor may prescribe anti-emetic meds to help reduce the vomiting.
• Alcohol. Drinking too much alcohol can cause vomiting.
• Food Allergy. Vomiting can be the only symptom of a food reaction. The vomiting comes on quickly after eating the food. Common foods are peanuts, tree nuts, fish and shellfish (such as shrimp).
• Motion Sickness. Vomiting and dizziness can be triggered by motion. Car travel, sea sickness or fun-park ride sickness are the most common types. It is strongly genetic.
• Migraine Headaches. Vomiting often happens with migraine headaches.
• Raised Pressure in the Brain can cause vomiting. This could result from a head injury; vomiting may happen at the time of the injury or days or weeks afterwards. It is a serious symptom and could mean there has been damage to the brain or bleeding inside the skull. Brain tumors and meningitis can also cause the pressure in the brain to increase.
• Liver Disease. Hepatitis A and B and liver cirrhosis can all cause nausea and vomiting. There may be other symptoms such as yellow skin and yellow in the whites of the eyes.
• Pregnancy. See Morning Sickness care guide.
• Ear Problems. Infection or problems in the inner ear that affect balance can cause dizziness, nausea and/or vomiting.

Serious Causes

• Vomiting alone (without diarrhea) should stop within about 24 hours. If it lasts more than 24 hours, you must think about more serious causes. Examples are appendicitis, a kidney or bladder infection, diabetes, blockage of the bowel and head injury.
• Vomiting Blood (serious) can be caused by stomach ulcers or by a rupture of veins at the entrance to the stomach. The blood may look brown, dark red or bright red. Bright red blood means that the bleeding is active (happening now). Call 911 if you are vomiting large amounts of blood (life-threatening). If you have been vomiting with force, it can sometimes cause small tears in the lining of your esophagus. You may see just a streak of bright red blood. It is best to get checked out if you vomit any amount of blood.
• Cyclic Vomiting is the most common cause of recurrent attacks of vomiting. Attacks have a sudden onset and offset.
• Stomach Problems. These include stomach ulcers and GERD (gastroesophageal reflux disease). GERD is when acid flows up the esophagus from the stomach.
• Diabetes. If you have diabetes, vomiting should not be ignored. It can mean your diabetes is out of control. Or it can make your diabetes hard to manage. Contact your doctor if you start to vomit.
• Addison's Disease and Hypercalcemia (high calcium levels) are much less common than diabetes, but can also have symptoms of nausea and vomiting.

Vomiting Scale

• Mild: 1 - 2 times/day
• Moderate: 3 - 7 times/day
• Severe: vomits everything or nearly everything or 8 or more times/day
• Severity relates even more to how long the vomiting lasts. At the start of the illness, it's common to vomit everything. This can last for 3 or 4 hours and then occur less often.
• The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
• The elderly and people with chronic disease are at the greatest risk for dehydration.

Dehydration: How to Tell

• The main risk of vomiting is dehydration. Dehydration means the body has lost too much water.
• Vomiting along with watery diarrhea is the most common cause of dehydration.
• Dehydration is a reason to see a doctor right away.
• You may have dehydration if not drinking much fluid and:
  • Urine is dark yellow and you are not passing urine as often as you normally would.
  • Inside of the mouth and tongue are very dry.
  • Slow blood refill test: longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.
  • If you have severe dehydration, you may be too weak to stand. You can also be very dizzy when trying to stand.

When to Call for Vomiting

Care Advice for Mild Vomiting

What You Should Know about Nausea and Vomiting:

• There are many causes of nausea and vomiting.
• Most vomiting is caused by a viral infection of the stomach. Sometimes, mild food poisoning is the cause.
• Early pregnancy is another cause in women.
• Motion sickness (sea sickness) affects some people badly.
• Vomiting is the body's way of protecting the lower gut.
• The good news is that most stomach illnesses last only a short time.
• There may be diarrhea or stomach pain, as well.
• The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
• Here is some care advice that should help.

Food and Drinks:

• Keep taking sips of water or diluted juice to stay well-hydrated. Signs of dehydration are dark urine and not passing urine as often as you normally would. You may feel dizzy when you get up from sitting.
• If you are keeping the fluids down, you can increase the amount you drink.
• Avoid alcohol.
• Avoid all solid foods while you are vomiting.
• After 8 hours without throwing up, slowly add them back.
• Start with starchy foods that are easy to digest. Examples are cereals, crackers and bread.
• Avoid fatty and overly spicy foods.
• If you are keeping the food down, slowly return to your normal diet.

Do Not Take Medicines:

• Stop using any drug that is over-the-counter for 8 hours. Reason: some of these can make vomiting worse.
• Fever. Mild fevers don't need to be treated with any meds. For higher fevers, you can use an acetaminophen suppository. This is a form of the drug you put in the rectum (bottom). Ask a pharmacist for help finding this product. Do not use ibuprofen. It can upset the stomach.
• Exception: Call your doctor if:
• You vomited after taking meds ordered by your doctor
• You have diabetes

Motion Sickness:

• Avoid reading, trying to watch a movie or playing electronic games while you are moving (often in a car or on a bus).
• Move position. In the car, move to the front seat. On a boat, move to the middle of the deck.
• If you are a driver, it may help for you to drive the car.
• Take a break from your travel and get some fresh air.
• Take sips of cold water.
• Travel sickness meds may help. Always follow the dosage stated on the package. Some meds for motion sickness can cause drowsiness. Do not drive or operate machinery if drowsy.

Try to Sleep:

• Get plenty of rest and try to sleep for a few hours if you can.
• Reason: sleep often empties the stomach and removes the need to vomit.

Return to Work and Other Activities:

• You can return to work and other activities after the vomiting and other symptoms (fever, diarrhea) are gone.

What to Expect:

• For the first 3 or 4 hours, you may vomit everything. Then the stomach settles down.
• Vomiting from a viral illness often stops in 12 to 24 hours.
• Mild vomiting and nausea may last up to 3 days.

Call Your Doctor If:

• You vomit clear fluids for more than 8 hours
• Vomiting lasts more than 24 hours
• Blood or bile (green color) in the vomit
• Stomach pain is present even when not vomiting
• You feel dehydrated (no urine in over 8 hours, dark urine, very dry mouth)
• You can't keep down prescribed medicines
• You think you need to be seen
• Your symptoms get worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.




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