What's up with upchucking: Your vomit questions, answered

Throwing up is something most of us don’t like to think about often, but it happens to just about everyone.

As gastroenterologists, Drs. Peter Stanich and Gokul Bala spend a lot more time thinking and talking about vomit than the average person. Stanich’s work in gastroenterology, hepatology and nutrition includes specialized care for colon cancer prevention, and Bala’s gastroenterology interests focus on esophageal disorders, swallowing conditions and motility (the ways that things move through our digestive systems).

Below, Stanich and Bala answer common questions about tossing your cookies:

When should I go to the Emergency Department for vomiting?

Stanich: If you see any blood in your vomit, that’s when you should head to the Emergency Department. That includes red blood, dark-black digested blood or dark brown bits that look like coffee grounds. I would also head to the ED if you begin to feel signs of dehydration, like lightheadedness or feeling like you’re going to pass out.

Bala: The other thing is when you have intense pain with vomiting. You could have pancreatitis, an obstruction in the bowels, a kidney stone or other severe condition, so that means that emergency care is warranted.

When should I call my doctor about vomiting?

Stanich: Call your doctor if you have vomiting that seems out of the ordinary for you or lasts longer than 24 hours.

Bala: There’s a difference between acute and chronic vomiting – acute vomiting typically happens because of a temporary trigger, such as a virus, seasickness, etc. Most of the time, that kind of vomiting is unpleasant but won’t require medication.

Chronic vomiting may continue on and off for weeks, months or years, and in those cases, managing it is different. It may be triggered by another condition, such as migraines, anxiety or depression, severe acid reflux, a blockage in the digestive system, severe constipation or gastroparesis (a disorder in which the stomach doesn’t empty food quickly enough).

What does it mean if my vomit is green/yellow/blue/orange/brown?

Stanich: As a doctor, it doesn’t make much difference to me if it’s green or yellow or contains spit or bile – as long as vomit doesn’t contain blood, the color doesn’t tell me what underlying condition you might have or what treatment you might need. It may just indicate what you ate earlier.

Bala: The things we look for in vomiting have more to do with other symptoms of common underlying conditions that cause vomiting. We look at whether you have pain elsewhere in the body, blurry vision or other co-existing symptoms. Vomiting is hard to treat because we need to pinpoint its trigger, and a patient may have two or three underlying conditions triggering it.

Is it ever a good idea to make myself throw up, when it seems like I might feel better?

Bala: Technically, it’s not possible to choose to vomit or not – vomiting is a reflexive mechanism. But I don’t recommend trying to hold it in if you’re in a safe place to vomit. It’s true that if you’re vomiting because of nausea, you may feel better afterward.

Stanich: However, inducing vomiting is typically a bad idea. If you don’t actually have to vomit, you’re unnecessarily inviting some of the side effects that can come along with vomiting, including the very rare but real esophageal rupture.

Are there effective home remedies to help me stop vomiting or feel less nauseated?

Bala: There aren’t many home remedies for nausea or vomiting that are backed by scientific evidence. If you’re able to eat anything, it’s best to try some light crackers, juice or ginger ale instead of something heavier, like a fatty or oil meal. We do know that fatty meals are harder to digest. And drink water between vomiting episodes whenever possible. It’s easier said than done, but staying hydrated is important.

Stanich: A lot of people use ginger for nausea and vomiting. It’s not clear how beneficial that is in the end, but if it seems to help you feel better, you can try that. The key is taking in plenty of liquids to stay hydrated, whether that’s water or a sports drink or similar electrolyte solution.

Bala: If you can make your surrounding environment calm, that can also help. I typically recommend doing deep-breathing exercises if you can – counting from one to five while taking deep breaths.

What can I do to help my body recover from episodes of vomiting?

Bala: Knowing what to eat can be a game of trial and error, but again, avoid fatty or oily foods that are harder to digest. Maintain hydration and try small, frequent meals.

Stanich: Rest, hydration and a very bland diet can help.