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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.

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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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