Vomiting is the body’s natural mechanism for getting rid of harmful substances and irritants in the upper gut (esophagus, stomach and upper part of the small intestine). It can even be a life-saving mechanism when a person consumes poisonous substances that could result in death. However, vomiting can sometimes be severe and persistent when it arises as a symptom of certain diseases. This can lead to complications.
Every person will experience vomiting every now and then. Sometimes it occurs once off with certain dietary or lifestyle factors, like overeating or excessive alcohol consumption. At other times, vomiting occurs as a result of diseases like gastroenteritis or food poisoning which are acute. Vomiting in these cases stops within a few hours to a few days. However, vomiting can also occur with chronic diseases and may be ongoing for long periods of time.
Read more on vomiting.
Is Vomiting Dangerous?
Vomiting itself is a potentially life-saving mechanism at times but when it is severe or persistent over the long term then it can be dangerous. The danger lies in the complications of vomiting. These complications include dehydration, electrolyte imbalances, esophageal tears and malnutrition. If these complications are severe or ongoing then it may result in significant health risks and possibly even culminate in death.
Since vomiting is a symptom, it is important to treat the underlying cause to resolve the vomiting as soon as possible or at least minimize the severity of vomiting. This may reduce the risk of complications and the associated dangers. However, when vomiting is not promptly treated and apprporiately managed then it is potentially dangerous. This is more applicable when vomiting is profuse, long term and hampers normal rehydration and diet.
Complications of Vomiting
The following complications of vomiting can vary from mild to severe. Sometimes these complications may not present with little to no symptoms when mild. The degree of the symptoms does not necessarily indicate the severity. It is possible for severe complications to be present with only minor symptoms. If the vomiting is short-lived, rehydration occurs promptly and normal dietary habits are resumed quickly then the complications may be avoided.
This is one of the most common complications of severe vomiting. In conditions where even fluids cannot be tolerated and are vomited out, dehydration from vomiting is very likely to develop in a short period of time. It is also more likely to occur faster if there is profuse watery diarrhea as well. The loss of fluid and electrolytes can be dangerous and even deadly.
Symptoms of dehydration include:
- Dry mouth
- Dry eyes
- Dry skin
- Extreme thirst
- Little to no urine
- Sunken eyes and cheeks (infants)
Read more on dehydration.
Electrolye abnormalities arise without proper replenishment or fluid and electrolytes in severe or prolonged vomiting. This includes abnormalities such as hypokalemia (low potassium) and metabolic alkalosis (high blood pH). The signs and symptoms may vary but these electrolyte abnormalities can be very severe and dangerous. It can affect breathing, heart activity and even brain or nerve function.
Symptoms of electrolyte abnormalities includes:
- Tremors, twitches and muscle spasms (cramping).
- Muscle weakness or paralysis
- Difficulty breathing
Tears in the esophagus can arise with prolonged and very forceful vomiting. These tears can be partial like a Mallory-Weiss tear where it does not extend through the esophageal wall. It can also be complete where the tear extends through the entire esophageal wall. This is known as Boerhaave syndrome. Sometimes severe and repeated vomiting only weakens the wall of the esophagus and the tear may occur later due to some other mechanism.
Symptoms of esophageal tears include:
- Chest pain (usually central / behind the breastbone)
- Discomfort when breathing
- Coughing up or vomiting blood
- Abdominal pain
Malnutrition is more likely to occur with chronic vomiting. This is a result of a loss of appetite that tends to occur with vomiting as well as the inability to retain sufficient quantities of food for adequate nourishment. Malnutrition can have a host of effects such as unintentional weight loss, lowered immunity, impairement of cognitive abilities and so on. Certain diseases may also arise like scurvy due to the lack of vitamin C or anemia due to iron deficiency.
Malnutrition may not always present with obvious symptoms, especially in the early stages. Some of the symptoms that may arise are largely non-specific and include:
- Weight loss
- Sleep disturbances
How Can Vomiting Complications Be Avoided?
Most of the complications of vomiting revolve around impaired nutrition and hydration. Therefore the complications associated with vomiting can be avoided to some degree. However, complications like esophageal tears are may not be preventable unless the underlying cause is treated to stop vomiting altogether. These are some of the dietary and lifestyle measures that may assist with preventing vomiting complications and its associated dangers.
Read more on how to stop vomiting.
- Sip on oral rehydrating solutions (ORS). It should be prepared according to instructions and be room temperature or slightly chilled. Soda is not a suitable ORS for rehydration.
- Do not consume alcohol or caffeinated beverages. These substances are diuretics and can hasten fluid loss through increased urination.
- Attempt to eat small amounts of food when the vomiting subsides. These foods should not be processed or preserved. Freshly prepared bland foods are the better option.
- Eat several times in a day rather than three large meals. Smaller quantities may be better tolerated and less likely to result in profuse vomiting.
- Try the BRAT diet when starting on solids after an episode of vomiting. This includes bananas (preferably mashed), rice, apples (grated or applesauce) and toast (no butter or other condiments). These foods are found to be better tolerated in nausea and vomiting.
- Avoid sleeping or lying flat immediately after eating solid foods. Mild physical activity can help but strenuous activity must be avoided.
- Do not exercise or remain in hot environments. Profuse sweating can cause further loss of essential water and electrolytes.
- Seek immediate medical attention if fluids cannot be retained. This prevents rehydration and an intravenous (IV) drip is necessary to avoid complications.