Vomiting – Causes, Symptoms and Treatment
Vomiting is the involuntary expulsion of stomach contents through the mouth. It is a common symptom with a wide range of possible causes.
Things worth knowing about "Vomiting"
Vomiting is the involuntary expulsion of stomach contents through the mouth. It is a common symptom with a wide range of possible causes.
What is Vomiting?
Vomiting (medically referred to as emesis) is the involuntary, forceful expulsion of stomach contents through the mouth. It is a protective reflex controlled by the vomiting center in the brain. Vomiting is often preceded by a feeling of nausea. It is not a disease in itself but rather a symptom that can indicate a wide variety of underlying conditions.
Causes
The triggers of vomiting are diverse and can be both physical and psychological in nature:
- Gastrointestinal infections (e.g., viral or bacterial gastroenteritis)
- Food poisoning from contaminated food
- Motion sickness (kinetosis) triggered by movement
- Pregnancy (morning sickness or hyperemesis gravidarum)
- Medications such as chemotherapy drugs, antibiotics, or pain relievers
- Migraine and severe headaches
- Alcohol or other toxic substances
- Psychological causes such as severe stress, anxiety, or eating disorders
- Stomach conditions such as gastritis or peptic ulcers
- Neurological causes such as increased intracranial pressure or meningitis
Symptoms and Associated Complaints
Vomiting frequently occurs alongside other symptoms:
- Nausea and retching
- Abdominal cramps or stomach pain
- Sweating and pallor
- Dizziness
- Diarrhea (in gastrointestinal infections)
- Fever (in infectious causes)
Diagnosis
Determining the cause of vomiting involves a thorough medical history and physical examination. Depending on the suspected cause, the following tests may be necessary:
- Blood tests (e.g., inflammatory markers, electrolytes)
- Urine analysis
- Abdominal ultrasound
- Upper endoscopy (gastroscopy)
- Imaging procedures (CT scan, MRI) if a neurological cause is suspected
Treatment
General Measures
The first priority is to restore fluid and electrolyte balance, as vomiting leads to significant loss of water and minerals. Small sips of water, oral rehydration solutions, or clear broths are recommended. Solid foods should be avoided initially.
Medication
In cases of persistent or severe vomiting, antiemetics (medications that reduce nausea and vomiting) may be prescribed, such as:
- Metoclopramide (MCP): promotes gastric emptying
- Dimenhydrinate: particularly effective for motion sickness
- Ondansetron: commonly used for chemotherapy-induced vomiting
- Domperidone: acts centrally to suppress the vomiting reflex
Treating the Underlying Cause
Long-term management requires addressing the root cause, such as treating an infection, discontinuing a causative medication, or managing a migraine disorder.
When to See a Doctor
Medical attention should be sought promptly in the following situations:
- Vomiting blood or coffee-ground-like material
- Persistent inability to keep any fluids down (risk of dehydration)
- Severe abdominal pain or a rigid abdomen
- High fever
- Signs of dehydration: dry mouth, minimal urination, weakness
- Vomiting following a head injury
- Prolonged vomiting in infants or young children
References
- Herold, G. et al. - Internal Medicine. Self-published, Cologne (current edition).
- World Health Organization (WHO) - Management of diarrhoea and vomiting in infants and young children. WHO Press.
- Lacy, B. E. et al. - Nausea and Vomiting: New Understanding and Management. Gastroenterology Clinics of North America, 2011.
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