Causes of Projectile Vomiting
What is projectile vomiting?
Projectile vomiting is when you vomit so forcefully that the vomit lands several feet away from you. It is difficult to control.
Projectile vomiting in adults is caused by the same types of illnesses that cause nausea and less intense vomiting. These include stomach viruses and food poisoning. Projectile vomiting can also happen when you have a migraine or are pregnant.
While projectile vomiting can make you feel really awful, most of the conditions that cause it aren’t serious and can be treated at home. What’s most important is that you drink plenty of fluids.
You may need to see your doctor if you can’t keep down any food or drink, the vomiting lasts for more than a few days, or you have other worrisome symptoms such as severe abdominal pain or fever.
1. Food poisoning
The most important thing is to try to stay hydrated. Many of the things that cause projectile vomiting are self-limited, meaning that they will resolve on their own with time. However, it is important that you don’t get too dehydrated. Try to drink small sips of liquids frequently. —Dr. Leila Mufdi
- Projectile vomiting
- Watery or bloody diarrhea
- Stomach cramps
Food poisoning is an irritation of the digestive tract caused by contaminated food or drinks. Symptoms typically appear several hours to 2 days after you’ve consumed contaminated food or drink. Food poisoning can be caused by exposure to bacteria such as salmonella, E.coli, and vibrio.
Symptoms usually go away on their own within a day or two. Although uncomfortable, the vomiting (and diarrhea) happen for a reason: They help your body get rid of the toxins that were in the contaminated food or drink.
Because food poisoning can cause severe vomiting and diarrhea, you’re at risk of becoming dehydrated. Signs of dehydration include being very thirsty, dry mouth, having little to no urination, and dizziness.
Call your doctor if you can’t keep down any food or fluids or if your symptoms are not improving within 2 to 3 days. Your doctor may give you medications to help your symptoms.
2. Gastroenteritis (stomach flu)
- Vomiting or projectile vomiting
Gastroenteritis is an inflammation of the stomach and intestines. It is often called “stomach flu,” but it is not a type of influenza (the flu).
Gastroenteritis can be caused by bacteria or viruses, such as norovirus, rotavirus, and adenovirus. They spread through contact with someone who has a virus, by touching an object they’ve touched, and by exposure to the virus or bacteria in food or drink.
Always wash your hands thoroughly after using the restroom, before and after food preparation, and before eating.
Symptoms usually go away on their own. But you must rest and drink a lot of fluids. If you can’t keep down any food or fluids for more than a day or two, you may need IV fluids and medicines to help control your vomiting.
A migraine is an intense headache that can cause a throbbing pain or a pulsating sensation in your head. It can last for hours or a few days and can interfere with your ability to function. Stimulation of the nerves that are involved in migraines can cause nausea and vomiting in some people with migraines.
People who get migraines typically have more than one migraine in their lives. Some people get them frequently. There are many triggers, including hormonal changes (in women), alcohol and caffeinated drinks, stress, and sleep changes.
Call your doctor if your migraine symptoms don’t improve within 2 to 3 days or if you can’t keep down any food or fluids. Also call the doctor if the pain feels different from migraines you’ve had in the past.
Treatment for migraines can include medications to reduce the pain. These include over-the-counter pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve).
For more severe migraines, your doctor may prescribe other medications such as a triptan, which can help treat all your migraine symptoms, including nausea. There are also options that help prevent future migraines such as beta blockers or certain types of antidepressants.
Projectile vomiting might be described as forceful vomiting that “shoots” out of the mouth. A change in diet shortly prior to the start of symptoms may suggest food poisoning. —Dr. Mufdi
- Vomiting or projectile vomiting
- Mild stomach pain
Morning sickness causes nausea and vomiting in pregnant women, especially during the first trimester. This may be related to the hormonal changes of pregnancy.
Women can help reduce symptoms by eating small, regular meals. Some women feel better when they eat foods and drinks that contain ginger, which soothes the stomach. You can also ask your doctor if they would recommend taking certain supplements, such as vitamin B6, that may help with morning sickness.
Some women may have severe vomiting and nausea throughout their pregnancy. This is called hyperemesis gravidarum. It can lead to serious problems, such as dehydration, weight loss, and preterm labor. You may need to take medications that reduce vomiting or get IV fluids or tube feeding in the hospital.
Projectile vomiting in infants and children
Projectile vomiting in infants and children can be serious because they can easily become dehydrated.
It is important to know the difference between spit up and projectile vomiting. Spitting up is a more common problem than projectile vomiting. Infants may spit up frequently due to reflux, heartburn, sensitivity to milk or formula, or large feedings.
Projectile vomiting, on the other hand, may be a sign of a more serious problem. If your infant projectile vomits more than once, call your pediatrician.
Infants and babies may projectile vomit when they have viral or bacterial infections. Watch for signs of dehydration, such as decreased urine production and decreased levels of interaction or activity.
In infants under 6 months, severe projectile vomiting can be caused by pyloric stenosis, a narrowing in the lower portion of the stomach. This narrowing makes it difficult for food to leave the stomach. Surgery is needed to treat pyloric stenosis.
Projectile vomiting can also be a sign of an allergic reaction in infants and children. If your child has other symptoms, such as hives, call your pediatrician. If they have difficulty breathing, go to the ER.
Other possible causes
Several other conditions can cause projectile vomiting. However, these may be rare or have other main symptoms besides projectile vomiting. These conditions include:
- A gastric (stomach) obstruction
- A mass in the stomach or intestines
- Significant head injury
- Side effect of certain medications
When to call the doctor
Scientists have developed models or vomiting machines to study and learn how toxins and viruses are spread when someone vomits. This information will allow medical professionals and scientists to provide education regarding how to limit spread of the stomach flu. —Dr. Mufdi
If your symptoms last longer than a day or two, call your doctor. You may need to take anti-nausea medication.
If you are projectile vomiting and have diabetes, call your doctor right away. Vomiting often can make it hard to manage your blood sugar.
Should I go to the ER for projectile vomiting?
You should go to the ER for the following:
- Blood in your vomit
- Bloody diarrhea
- Severe abdominal pain
- Inability to keep anything down
- Greenish vomit (this can be a sign of a blockage or obstruction in your digestive tract)
- Infants under 6 months who project vomit more than once
- Signs of dehydration like not urinating a lot and decreased activity, especially in infants and children
- Drink water and clear fluids, such as broth and pulp-free juice. Electrolyte-replacement solutions, such as sports drinks and Pedialyte, can be helpful.
- Eat bland foods like crackers and toast.
- Fever can be treated with over-the counter-medications such as Tylenol. Controlling your fever and pain may help you feel well enough to drink liquids.
- Medications that settle your stomach (like Pepto Bismol) may also be helpful.
Other treatment options
- You may need IV fluids if you can’t keep fluids down and become dehydrated.
- In some cases of projectile vomiting, such as pregnancy or a reaction to medication, you may need anti-nausea medication.
- If projectile vomiting is because of an obstruction or blockage in your digestive tract, you may need surgery.
Dr. Mufdi is a board-certified emergency medicine physician. She obtained her undergraduate degree in neurobiological sciences at the University of Florida. She attended Chicago College of Osteopathic Medicine and completed an emergency medicine residency at Albert Einstein Medical Center in Philadelphia. Recognizing the value of health literacy, she is happy to have joined Buoy Health in 2021.