Vomiting may be due to a large number of causes, and
protracted vomiting has a long
differential diagnosis.
Digestive tract Causes in the
digestive tract •
Gastritis (
inflammation of the gastric wall) •
Gastroenteritis •
Gastroesophageal reflux disease •
Celiac disease •
Non-celiac gluten sensitivity •
Pyloric stenosis (in babies, this typically causes a very forceful "projectile vomiting" and is an indication for urgent surgery) •
Bowel obstruction •
Overeating (stomach too full) •
Acute abdomen and/or
peritonitis •
Ileus •
Food allergies (often in conjunction with
hives or
swelling) •
Cholecystitis,
pancreatitis,
appendicitis,
hepatitis •
Food poisoning • In children, it can be caused by an
allergic reaction to cow's
milk proteins (
milk allergy or
lactose intolerance)
Sensory system and brain Causes in the
sensory system: • Movement leading to
motion sickness (which is caused by overstimulation of the labyrinthine
canals of the ear) •
Ménière's disease •
Vertigo Causes in the
brain: •
Concussion •
Cerebral hemorrhage •
Cerebral aneurysm •
Migraine •
Brain tumors, which can cause the chemoreceptors to malfunction •
Benign intracranial hypertension and
hydrocephalus Metabolic disturbances (these may irritate both the stomach and the parts of the brain that coordinate vomiting): •
Hypercalcemia (high
calcium levels) •
Uremia (
urea accumulation, usually due to
kidney failure) •
Adrenal insufficiency •
Hypoglycemia •
Hyperglycemia •
Endometriosis Pregnancy: •
Hyperemesis,
morning sickness Drug reaction (vomiting may occur as an acute
somatic response to): •
Alcohol, which can be partially oxidized into
acetaldehyde that causes the symptoms of
hangover, including nausea, vomiting, shortness of breath, and fast heart rate. •
Opioids •
Selective serotonin reuptake inhibitors • Many
chemotherapy drugs • Some
entheogens (such as
peyote or
ayahuasca)
High altitude: •
Altitude sickness Illness (sometimes colloquially known as "
stomach flu"—a broad name that refers to gastric inflammation caused by a range of viruses and bacteria): •
Norovirus (formerly Norwalk virus or Norwalk agent) •
Swine influenza Psychiatric/behavioral: •
Bulimia nervosa •
Food neophobia •
Purging disorder Emetics An
emetic, such as
syrup of ipecac, is a substance that induces vomiting when administered orally or by injection. An emetic is used medically when a substance has been ingested and must be expelled from the body immediately. For this reason, many toxic and easily digestible products such as rat poison contain an emetic. Inducing vomiting can remove the substance before it is absorbed into the body. Emetics can be divided into two categories: those which produce their effect by acting on the vomiting center in the medulla, and those which act directly on the stomach itself. Some emetics, such as ipecac, fall into both categories: they initially act directly on the stomach, while their further and more vigorous effect occurs by stimulation of the medullary center.
Salt water and
mustard water, which act directly on the stomach, have been used since ancient times as emetics. Care must be taken with salt, as
excessive intake can potentially be harmful.
Copper sulfate was also used in the past as an emetic. It is now considered too toxic for this use.
Hydrogen peroxide is used as an emetic in veterinary practice.
Self-induced •
Eating disorders (
anorexia nervosa or
bulimia nervosa) • To eliminate an ingested poison (some poisons should not be vomited as they may be more toxic when inhaled or aspirated; it is better to ask for help before inducing vomiting) • Some people who engage in
binge drinking induce vomiting to make room in their stomachs for more alcohol consumption. • Participants in
milk chugging typically end up vomiting most of the milk they consume, as proteins in the ingested milk (such as
casein) rapidly denature and unravel on contact with gastric acid and
protease enzymes, rapidly filling the stomach. Once the stomach becomes full,
stretch receptors in the stomach wall trigger signals to vomit to expel any further liquid the participant ingests. • People suffering from
nausea may induce vomiting in hopes of feeling better.
Miscellaneous • After
surgery (
postoperative nausea and vomiting) • Disagreeable sights or
disgust, smells, tastes, sounds or thoughts (such as decayed matter, others' vomit, thinking of vomiting), etc. • Extreme pain, such as an intense
headache or
myocardial infarction (heart attack) • Extreme
emotions •
Cyclic vomiting syndrome (a poorly understood condition with attacks of vomiting) •
Cannabinoid hyperemesis syndrome (similar to
cyclic vomiting syndrome, but has cannabis use as its underlying cause). • High doses of
ionizing radiation sometimes trigger a vomit reflex. • Violent fits of
coughing,
hiccups, or
asthma •
Anxiety •
Depression •
Overexertion (doing too much strenuous exercise can lead to vomiting shortly afterwards).
Other types •
Projectile vomiting is vomiting that ejects the gastric contents with great force. It is a classic symptom of
infantile hypertrophic pyloric stenosis, in which it typically follows feeding and can be so forceful that some material exits through the nose. ==Treatment==