Vomiting and Diarrhea: Causes, Symptoms and Treatments

A nauseated man holds his hands over his mouth

What's worse: Vomiting or diarrhea? Trick question: Neither. Both involve spending far too much time in the bathroom, and when you have them simultaneously, well, that's a whole other level of trouble.

Experiencing vomiting and diarrhea together is usually due to a viral illness or bacterial infection that affects the gastrointestinal (GI) system. That said, it could be something else is going on. We asked a few experts to give us the low-down on this digestive double-whammy—here's what they said.

What Causes Vomiting and Diarrhea at the Same Time?

Vomiting and diarrhea can happen together for different reasons, but the most likely cause is gastroenteritis, says Harmony Allison, M.D., gastroenterologist at Tufts Medical Center, Boston, MA. This digestive condition is characterized by inflammation and irritation of the stomach and intestines.

Gastroenteritis

The most common causes of gastroenteritis (sometimes called a "stomach flu") are viruses, says the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). They include:

Norovirus
Rotavirus
Adenovirus
Astrovirus

"Of these, the most common is probably norovirus—the notorious plague of cruise ships everywhere," Dr. Allison adds.

Gastroenteritis can also be caused by bacteria, including:

Salmonella
Campylobacter
Shigella
E. Coli

Parasites like giardia or cryptosporidium can cause gastroenteritis, too, says Dr. Allison.

Food Poisoning

"Food poisoning" is another name for gastroenteritis, Dr. Allison explains, and norovirus is the most likely culprit, says the Cleveland Clinic. This virus typically spreads when someone who has been infected touches food before serving it to someone else. Norovirus symptoms (like vomiting and diarrhea) usually start 12 to 48 hours after you come into contact with the virus, and last for up to three days—although it may feel like a lot longer!

Traveler's Diarrhea

When it affects someone who's traveled to another country, gastroenteritis is sometimes called traveler's diarrhea. Typically, the sufferer has been to a part of the world with poor water purification and been exposed to viruses or bacteria through drinking local water, or by eating foods that have been improperly handled or washed in local water, per the MSD Manual. Even brushing your teeth with a toothbrush you rinsed in tap water or drinking bottled drinks with ice made from local water can cause infection. Traveler's diarrhea is characterized by vomiting and diarrhea, as well as nausea and abdominal cramping.

Overeating or Overdrinking

You may know it as the dreaded hangover, and for good reason: Sometimes vomiting and diarrhea is self-inflicted from too much alcohol, but you can get a "food hangover" too, says Tamara Freuman, R.D., a registered dietitian at New York Gastroenterology Associates and author of The Bloated Belly Whisperer.

"You can get diarrhea just from overeating in general—a heavy restaurant meal, a holiday party, and so on," Freuman says. Overdoing it on a specific food group can do you in, too. "Sometimes, people get diarrhea if they overeat fiber, fat, or high lactose foods like ice cream or milk—including lattes, cappuccinos, and the like—or diet foods with lots of sugar alcohols—the sweeteners that end with ol, like sorbitol, xylitol, lactitol, mannitol, erythritol, and maltitol." It's a matter of your personal food sensitivities—what's inconsequential for your tablemate may send your stomach seizing.

Stress or Anxiety

A greater awareness of the mechanisms behind stress and anxiety has led to an understanding of how emotional distress can result in physical symptoms.It's linked to your body's natural response to a perceived threat (i.e. stress), known as "fight-or-flight", explains the American Psychological Association (APA). Your reaction to the activation of the sympathetic nervous system, which is made up of a complex network of nerves, can result in increased activity in the colon.

Pregnancy

Vomiting is a common symptom of pregnancy (or morning sickness, as it's typically called—although anyone who's ever been pregnant knows that it can happen at any point during the day). The majority of pregnant people will deal with nausea and vomiting (70% to 80%, studies show), but some may experience diarrhea, too. This may be due to hormonal changes, a pregnancy-related sensitivity to certain foods, a bowel infection, or an underlying bowel disorder, says the American Pregnancy Association.

Medications

Vomiting and diarrhea can arise as a side effect of certain meds, says Freuman. These include commonly prescribed drugs like the type 2 diabetes treatment metformin (Glucophage), as well as certain blood pressure drugs and acid-reducing medications.

Antibiotics may also cause vomiting and diarrhea, says the Mayo Clinic. In fact, about 1 in 5 people who take antibiotics develop antibiotic-associated diarrhea.

Diarrhea Symptoms

Symptoms of Diarrhea

The main symptom of diarrhea is passing loose, watery stools three or more times a day, says the NIDDK—but that's not the only symptom. Diarrhea can also cause:

Abdominal cramping and/or pain
An urgent need to use the bathroom
Loss of control of bowel movements
Nausea
If diarrhea is brought on by an infection, additional symptoms may include:
Bloody stools
Fever and chills
Light-headedness and dizziness
Vomiting

Vomiting Symptoms

Symptoms of Vomiting

Vomiting—also referred to as throwing up, retching, heaving, hurling, and puking—is, as all of us have probably experienced, the emptying of the stomach contents through the mouth. Per the Cleveland Clinic, vomiting can also lead to:

Abdominal pain
Decreased urination
Diarrhea
Dizziness
Dry mouth
Light-headedness

On its own, vomiting once or twice isn't usually something to worry about—we all get a stomach bug or contract an illness from time to time. The danger comes in the complications that stem from dealing with both vomiting and diarrhea together.

Complications

Complications of Vomiting and Diarrhea

The main complication of vomiting and diarrhea together is dehydration—a severe loss of water and essential salts and minerals. Dr. Allison says the physical signs of dehydration often include:

Dehydration is no joke, and long periods of it can be very, very harmful. So if you're vomiting and having diarrhea, it's imperative to replenish your body. "The best way to prevent dehydration is to keep up your fluid intake," says Dr. Allison. "If you're not able to do this, it's important to seek medical attention."

Treatment Options for Vomiting and Diarrhea

There's no specific medical treatment for viral gastroenteritis (remember, antibiotics aren't effective against viruses) but staying hydrated can make a big difference, says Dr. Allison. Fortunately, mild cases of dehydration can be treated at home with plenty of fluids and rest. And when we say fluids, we don't just mean water—feel free to drink what you like.

"Try to combine water with other fluids," says Dr. Allison, "such as broths, fruit juices, and commercially available rehydration drinks." Just stay away from caffeinated sodas, she adds, as caffeine can make an upset stomach worse.

You could also try anti-diarrhea meds, such as Imodium (loperamide) or Pepto-Bismol (bismuth subsalicylate), states the Mayo Clinic. However, avoid these if you have bloody diarrhea or fever, which could be signs of another condition. If those symptoms arise, you need to see a doctor.

Home Remedies

Home Remedies for Vomiting and Diarrhea

As far as home remedies go, there's a lot you can do to reduce vomiting and diarrhea. While there's not a ton of science to back it up, people have been using peppermint oil for hundreds of years to treat GI issues, says the National Center for Complementary and Integrative Health (NCCIH). This is due to its antimicrobial, anti-inflammatory, antioxidant, immune-boosting, and anesthetic properties. Peppermint oil can be taken orally in capsules, or diluted with water and inhaled.

Some research supports the use of ginger to soothe an upset stomach, which may help to reduce vomiting and diarrhea. Like peppermint oil, this herbal remedy has been used for centuries. Dr. Allison suggests sipping ginger ale, or making ginger tea with lemon.

To prevent vomiting and diarrhea from bacterial or viral infections, Freuman offers the following tips:

Avoid drinking tap water or eating raw veggies and fruits when traveling abroad to certain countries. Check with your doc before traveling.
Exercise caution when eating in risky situations for foodborne illness. Summer picnics and restaurant/supermarket buffets are biggies, as are undercooked burgers/ground meat.
Follow food safety practices when cooking at home. Observe recommended cooking temperatures for meat, wash all produce you plan to eat raw, and put cooked foods in the fridge promptly.

When to See Your Doctor

When to See Your Doctor for Vomiting and Diarrhea

In most cases, vomiting and diarrhea pass in a couple of days with rest and hydration. But Freuman recommends checking in with your doctor if:

There is blood in the stool (in the absence of a known hemorrhoid)
You're losing weight without trying
You are waking overnight with diarrhea
You have acute abdominal pain
You have such urgent diarrhea that it has resulted in accidents or near-accidents
Your symptoms are interfering with your life in problematic ways
Your symptoms have lasted for more than a few weeks

The Mayo Clinic advises seeking emergency care if you develop any of the following symptoms:

Blurred vision
Chest pain
Confusion
Fecal material or fecal odor in your vomit
High fever and stiff neck
Rectal bleeding
Severe abdominal pain or cramping

Don't forget that you know your body better than anyone else! If you haven't been diagnosed with gastroenteritis and there's no other obvious cause for your vomiting and diarrhea, it's better to be safe than sorry—so make that doctor's appointment.

This article was originally published May 20, 2008 and most recently updated October 30, 2023.

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