Why Am I Throwing Up and When To See a Doctor

You've been vomiting — a lot. And you might have questions like Why am I throwing up? Should I go to the doctor for the stomach flu?

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While you may be able to manage vomiting at home (making sure you're staying hydrated!), if you're experiencing vomiting for extended periods of time where you can't keep anything down, you should go to the ER.

"Potential causes of vomiting vary widely with a long list of possible explanations," says gastroenterologist Christine Lee, MD.

Dr. Lee explains the common reasons you can't stop throwing up, how you can manage it at home and when you need to seek medical attention.

Common reasons for throwing up

There are many reasons you can't stop vomiting. Dr. Lee says some of the most common reasons are:

Stomach flu (gastroenteritis).
Food poisoning.
Motion sickness.
Pregnancy.
Migraines.
Cancer treatments.
Fevers.
Bowel obstruction.

Some serious conditions such as a concussion, meningitis and appendicitis may also lead to vomiting.

What might be a sign to get medical attention

Some classic alarm features to look for when determining if an emergency room visit is necessary are if you're unable to keep anything down, your symptoms escalate or you experience any of the following:

Bleeding.
Lightheadedness.
Dizziness.
Chest pains.
Shortness of breath.
Weakness.
Numbness.
Lethargy or a change in mental alertness.

For the most part, again, if you have uncontrolled vomiting for extended periods of time where you can't keep anything down, you should go to the emergency room. This is especially true for the very young, the elderly or those with significant underlying health conditions, Dr. Lee says.

"Younger and older people are more vulnerable to complications from dehydration," she says. "They are more susceptible to kidney failure or electrolyte imbalances that can become serious."

There are several questions a doctor on call will ask (and you can ask yourself) in determining what the cause might be, as well as the most prudent course of action, Dr. Lee says.

Ask yourself these questions to see if and when to go to the ER for vomiting:

Are you vomiting blood? If the amount of blood is significant, Dr. Lee says you should go to the emergency room to rule out upper gastrointestinal bleeding.
Are you also experiencing diarrhea or bloody diarrhea? Dr. Lee says that can sometimes indicate an outbreak of food poisoning, which can last longer than 24 hours. "Salmonella and certain E. coli strains can be more serious if prolonged," she notes. Healthcare providers can also rule out colitis, inflammatory bowel disease or acute diverticulitis.
Was it something you ate? There's no way to know for certain, but if you have friends or family members you recently saw who are also ill "that lends itself to an infectious cause," Dr. Lee says. "If everyone who ate at a picnic all falls ill with the same symptoms, it's more than likely to be food poisoning."
Can you keep down clear fluids? If not, the inability to tolerate any clear liquids or keep anything down is a warning sign that medical attention may be needed, says Dr. Lee.
Do you have a fever? "That makes doctors think it's more likely to be an infection, although certain illnesses such as Crohn's disease or neoplastic syndromes can bring on fevers," Dr. Lee clarifies. Fevers are less likely to happen if the cause is just acid reflux or peptic ulcer disease.
Do you have other significant symptoms? Dr. Lee says other red flags include intense escalating abdominal pain, lethargy and mental confusion. "Those are big red flags, and you need to seek immediate medical attention."

Use these questions to help you identify red flags — reasons to visit an ER for vomiting rather than riding it out. If you're ever in doubt, call a healthcare provider.

How to manage vomiting at home

If you think you have an infection like the stomach flu or a mild case of food poisoning, you may be able to manage any vomiting at home. Dr. Lee offers the following tips:

Hydrate by drinking clear liquids. This can include water, clear broth and diluted juices. You can even suck on ice chips to stay hydrated.
Avoid solid food until the vomiting ends. Jell-O® and popsicles are good options. You can also try eating soft, bland foods like plain yogurt, plain oatmeal, bread and crackers.
Get extra rest. You want to take it easy to give your body time to recover. Avoid activity right after eating or drinking until the vomiting has stopped.
Pause certain medications. Temporarily stop taking all nonessential oral medications, health supplements and over-the-counter medications, which may irritate the stomach and make vomiting worse.

Bottom line?

If you've given it time and tried some at-home remedies and the vomiting fails to improve or resolve, you may need to seek medical help, as it could be a sign of other issues.

And if you've been throwing up, you should be concerned about dehydration. Vomiting for an extended period of time can result in a loss of fluids, making you feel dizzy and tired.

"If dehydration becomes a concern you may need to seek medical attention," stresses Dr. Lee.

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