Vomiting, or throwing up, is your body’s powerful reflex to expel harmful substances from your stomach and upper digestive system. While it’s a common experience, frequently finding yourself unable to keep food down can be a sign of an underlying issue that needs attention. This article explores the causes of vomiting, when it becomes a concern, and what you can do when you just can’t hold food down.
What is Vomiting and Why Does it Happen?
Vomiting is more than just a simple stomach upset. It’s a complex reflex involving strong contractions of your abdominal muscles, designed to rid your body of potentially dangerous substances. This forceful ejection distinguishes it from reflux or regurgitation, which occur without these strong muscle contractions. Sometimes, vomiting can be projectile, sending stomach contents a considerable distance.
Alongside the act of vomiting, you might experience other uncomfortable symptoms such as nausea, sweating, and increased saliva production. Retching, which involves the same forceful stomach contractions as vomiting but without expelling anything, can also occur.
Persistent vomiting can quickly lead to dehydration, a serious condition where your body loses more fluids than it takes in. Dehydration impairs normal bodily functions and requires prompt attention. If you are experiencing symptoms of dehydration alongside vomiting, it is important to seek medical advice.
Why Can’t I Keep Food Down? Common Causes of Vomiting
Occasional, short-lived vomiting is often due to acute issues that resolve quickly. However, if you are frequently struggling to hold food down, it could indicate chronic or recurring vomiting, which warrants investigation.
Acute Vomiting: Sudden Onset
Several conditions can cause sudden, acute vomiting, making it difficult to keep food down temporarily:
- Gastroenteritis (Stomach Flu): This digestive tract infection is a very common reason for sudden nausea and vomiting. Often viral, it usually clears up within a couple of days without specific treatment. During this time, even bland foods might be difficult to tolerate.
- Food Poisoning: Bacteria in improperly stored food can release toxins, leading to food poisoning and vomiting. Your body’s attempt to expel the contaminated food is why you might find yourself unable to keep anything down.
- Poisoning: Ingesting toxins or irritants can trigger vomiting as the body tries to eliminate the harmful substance.
- Motion Sickness: Disruptions to your inner ear balance, like during travel, can cause nausea and vomiting, making it hard to eat or drink.
- Excessive Alcohol: Drinking too much alcohol can irritate your stomach lining and lead to vomiting as your body attempts to get rid of the alcohol.
- Post-operative Nausea: Surgery and anesthesia can sometimes cause nausea and vomiting in the immediate recovery period.
- COVID-19: Nausea and vomiting are recognized symptoms of COVID-19, and can contribute to difficulty in keeping food down.
- Pancreatitis or Hepatitis: Inflammation of the pancreas or liver can cause abdominal pain, vomiting, and fever, making eating very challenging.
- Increased Intracranial Pressure: Elevated pressure inside the skull is a serious medical emergency and can manifest with nausea and vomiting.
- Meningitis: This infection presents with sudden, severe symptoms including vomiting, fever, stiff neck, and sensitivity to light.
- Diabetic Ketoacidosis: For individuals with diabetes, vomiting can be a sign of this dangerous complication.
- Other Acute Conditions: Conditions like bowel obstruction or appendicitis can also cause acute vomiting and inability to hold food down.
Chronic Vomiting: Persistent Issues
If you consistently find yourself unable to hold food down, or experience recurring episodes of vomiting, it could stem from chronic conditions:
- Radiation Therapy: Vomiting can be a side effect of radiation treatments, particularly if targeting the abdominal area.
- Pregnancy (Morning Sickness): Nausea and vomiting, commonly known as morning sickness, are frequent during early pregnancy and can occur at any time of day, making it hard to eat.
- Migraines: Nausea and vomiting are common symptoms associated with migraine headaches.
- Food Allergies or Coeliac Disease: Food allergies or intolerances like coeliac disease can cause chronic digestive issues, including vomiting after eating certain foods. This can directly contribute to not being able to hold food down.
- Upper Digestive Tract Disorders (GORD/GERD): Gastroesophageal reflux disease (GORD) can cause vomiting, especially after meals.
- Gastroparesis: Delayed stomach emptying due to nerve damage can lead to nausea and vomiting after eating, as food sits in the stomach for too long.
- Kidney Stones: Kidney stones can cause intense pain, nausea, and vomiting.
- Mental Health Conditions: Anxiety and depression can sometimes be associated with chronic nausea and vomiting.
- Functional Nausea and Vomiting: This refers to persistent nausea and vomiting where no underlying medical cause can be identified.
- Medication Side Effects: Certain medications can list nausea and vomiting as side effects.
Diagnosing Why You Can’t Keep Food Down
For a short episode of vomiting, pinpointing the exact cause might not be necessary. However, if you experience ongoing or recurrent vomiting and are consistently unable to hold food down, seeking medical advice is crucial.
Your doctor will take a detailed medical history, inquire about your symptoms, and perform a physical examination. To identify the cause, they might recommend tests such as:
- Blood Tests: To check for infection, electrolyte imbalances, or signs of other medical conditions.
- Urine Tests: To assess for dehydration, infection, or pregnancy.
- Pregnancy Test: If pregnancy is suspected as a possible cause of vomiting.
In cases where the cause of recurrent vomiting is unclear, further investigations like an endoscopy or CT scan might be recommended to get a clearer picture of your digestive system. Your doctor may also refer you to a specialist, such as a gastroenterologist (digestive system specialist) or neurologist (nervous system specialist).
When to Seek Medical Help for Vomiting
While managing vomiting at home is possible for mild cases like gastroenteritis, certain situations require prompt medical attention. It’s important to know when vomiting signals a more serious problem.
Seek Urgent Medical Care If:
- Vomit Contains Blood or Looks Like Coffee Grounds: This could indicate bleeding in your upper digestive tract.
- Vomit is Green (Bile): This could suggest a blockage in your intestines.
- Vomit Contains Faecal Matter (Poo): This is a serious sign of bowel obstruction.
- Severe or Constant Abdominal Pain: Intense pain accompanying vomiting can indicate conditions like appendicitis or pancreatitis.
- Stiff Neck and High Fever: These are symptoms of meningitis, a serious infection.
- Severe Headache: Combined with vomiting, a severe headache could be a sign of increased intracranial pressure or migraine.
- Rectal Bleeding or Bloody Diarrhoea: These symptoms alongside vomiting require immediate medical evaluation.
- Chest Pain: Vomiting accompanied by chest pain can be a sign of a serious underlying issue.
Seek Immediate Medical Attention (Doctor or Emergency Department) If You Are Vomiting and:
- Have a High Fever: Fever suggests infection.
- Show Signs of Dehydration: Symptoms include dry mouth, decreased urination, dizziness, and weakness.
- Can’t Keep Down Liquids: Inability to even sip water is a serious sign of dehydration risk.
- Vomiting Lasts More Than 48 Hours: Prolonged vomiting needs medical assessment.
- Are Immunocompromised: Weakened immune systems require quicker medical intervention for infections.
- Have Unexplained Weight Loss: Vomiting and weight loss without dieting can signal a significant underlying condition.
Treating Vomiting and Getting Back to Holding Food Down
Treatment for vomiting is focused on addressing the underlying cause. Some causes require specific medical interventions, while others can be managed with self-care.
Self-Care at Home When You Can’t Hold Food Down:
For vomiting due to gastroenteritis or food poisoning, staying hydrated is paramount. Try these self-care measures:
- Rest at Home: Avoid spreading infection by staying home.
- Hydrate with Clear Fluids or Oral Rehydration Solutions (ORS): Sip small amounts frequently. ORS are better than plain water as they replenish electrolytes. Avoid sugary drinks, fruit juice, and cordials as they can worsen diarrhea.
- Avoid Alcohol and Caffeine: These can dehydrate you further.
- Diet Adjustment: When you start feeling better, gradually reintroduce bland foods like rice, pasta, and crackers.
Medical Treatments for Vomiting:
- Oral Rehydration Solutions (ORS): Available over-the-counter, these are crucial for replacing lost fluids and electrolytes, especially when you can’t keep much down.
- Antiemetic Medications: Prescription antiemetics can help stop or prevent nausea and vomiting, particularly for migraines, motion sickness, post-surgery nausea, chemotherapy, and radiation therapy.
- Ginger: Ginger can be helpful for nausea and vomiting related to pregnancy, chemotherapy, and motion sickness.
Other Treatment Approaches:
- Dietary Changes: Eating smaller, less fatty, and bland meals can sometimes help reduce vomiting. Working with a dietitian can provide personalized dietary strategies.
- Surgery: Conditions like appendicitis or bowel obstruction causing vomiting require emergency surgery.
Preventing Vomiting
Preventing vomiting often involves avoiding the triggers. Since viral gastroenteritis is a common cause, practicing good hygiene is key:
- Frequent Handwashing: Use proper handwashing techniques.
- Food Safety: Practice safe food handling and storage.
- Avoid Preparing Food for Others if Sick: Prevent spreading infection.
- Stay Away from Vulnerable Settings: Avoid hospitals, aged care facilities, and swimming pools when ill.
- Properly Clean Vomit: Wear gloves, apron, and mask when cleaning vomit. Dispose of waste in a sealed plastic bag and disinfect the area.
Complications of Persistent Vomiting
Dehydration is a major complication of vomiting, leading to electrolyte imbalances. Sip clear fluids or ORS to prevent dehydration.
Chronic vomiting can lead to weight loss if you consistently can’t hold food down or experience prolonged nausea that suppresses appetite.
Vomiting can also interfere with medication absorption. If you vomit within 2 hours of taking oral contraceptives, they may be less effective, requiring backup contraception. Consult your pharmacist for advice.
Aspiration, where vomit enters the lungs, is another serious complication, potentially leading to pneumonia.
In rare cases, forceful vomiting can tear the oesophagus lining.
If you are concerned about your vomiting, especially if you can’t hold food down, use a symptom checker or consult a healthcare professional to determine the best course of action.
