If you vomit from time to time, you probably find it confusing and uncomfortable and you might ask yourself, “Why do I keep throwing up?” Vomiting that comes and goes is called intermittent emesis. These episodes can happen hours, days or even weeks apart.
Many of the things that cause intermittent emesis are not serious but it’s important to figure out what’s causing your vomiting.
Sean Rea, DO, a family medicine specialist with Banner Health, explained more about common causes, what helps and when to seek care.
What intermittent emesis means
Intermittent emesis is vomiting that happens in episodes, not continuously. These episodes might not last long but they keep coming back. Certain foods, stress or illnesses could cause them.
When you have these vomiting periods, you might also have nausea or an upset stomach. But they could also come on with no warning at all.
Why vomiting may come and go
Your digestive system can react to triggers like these over time:
- Infections
- Food
- Hormones
- Stress
- Medications
Watching for patterns can help clue you in to what’s causing intermittent vomiting.
Common causes of intermittent vomiting
Vomiting episodes could be caused by:
- Stomach infections: Viral gastroenteritis can cause vomiting episodes that last for one to three days and often include diarrhea, cramps and fatigue.
- Food intolerance or food poisoning: Food intolerance is triggered by certain foods and food poisoning is caused by eating contaminated food. Symptoms may start hours after eating and can repeat if you continue to eat these foods.
- Acid reflux or GERD: Irritation from stomach acid can lead to nausea or occasional vomiting. These symptoms may be worse after meals or when you’re lying down.
- Migraine-related nausea: You may vomit when you have migraines. It’s common for people who vomit when they have migraines to also be sensitive to light and sound.
- Medications or supplements: Antibiotics, pain medications and vitamins can irritate your stomach.
- Stress or anxiety: Your brain and gut are closely connected, so emotional stress can trigger nausea or vomiting called psychogenic vomiting.
- Cyclic vomiting syndrome: CVS is a disorder of the gut-brain interaction where you have repeated episodes of severe vomiting separated by times where you don’t have symptoms or you have nausea or an upset stomach but not vomiting. A health care provider can help figure out what’s causing it.
- Cannabinoid hyperemesis syndrome (CHS): Chronic cannabis use can cause vomiting. Hot showers usually relieve this type of vomiting. Using products that contain THC can relieve symptoms in the short term but quitting THC use is often the only way to treat CHS.
- Gastroparesis: Delayed gastric emptying (when your stomach empties too slowly) can cause vomiting, especially after high-fat meals or snacks.
- Other medical conditions: You may vomit due to gallbladder disease, pancreatitis or pregnancy.
Clues that point to specific causes
Be sure to pay attention to any possible links between vomiting episodes and possible triggers. This information can help your health care provider make a diagnosis.
- After eating: Possible food trigger or gallbladder issue
- With headaches: Possibly migraine-related
- During stress: Gut-brain connection
- At night or lying down: Reflux-related
- Repeated cycles: Possible cyclic vomiting syndrome
How doctors diagnose intermittent vomiting
“Diagnosis of intermittent vomiting is usually based on your history and physical examination,” Dr. Rea said. “Laboratory tests, imaging and endoscopic procedures are usually only needed for people with certain symptoms or unusual presentations.”
Your health care provider will ask you about:
- Symptoms and timing
- Diet and triggers
- Medication use
“Recognizing and managing intermittent vomiting early can shorten episodes, make them less frequent and severe and reduce emergency department visits,” Dr. Rea said.
Ways to feel better at home
Frequent vomiting can make you uncomfortable. It can help to:
- Sip small amounts of clear fluids or oral rehydration solutions throughout the day so you don’t get dehydrated
- Eat small, frequent meals of bland foods like bananas, rice and toast
- Avoid greasy, spicy or heavy meals
- Avoid any known triggers
- If you’ve been prescribed medications such as Zofran (ondansetron) or triptans, take them as soon as symptoms start
Warning signs that need medical attention
Contact a health care provider for:
- Vomiting that lasts more than 24 hours (adults) or 12 hours (children)
- Vomiting that recurs over several days
- Signs of dehydration such as dry mouth, dark urine, less urine than usual, confusion or dizziness
- Severe abdominal pain
- Vomit with blood or coffee-ground appearance
- Vomit with green or yellow bile
- Vomiting with a fever that does not improve
- Vomiting after a head injury
- An inability to keep fluids down
- Neurologic symptoms like severe headache, altered mental status, numbness or blurry vision
The bottom line on intermittent vomiting
A lot of different things could cause intermittent vomiting and many are treatable. “Even if there is no cure, managing the condition can improve your quality of life,” Dr. Rea said.
If vomiting keeps coming back or doesn’t improve, a Banner Health provider can help find the cause and recommend a care plan.
FAQs
What is intermittent emesis?
Vomiting that happens in episodes rather than continuously.
Why does my vomiting come and go?
It may be triggered by infections, food, stress, medications or underlying conditions.
Is intermittent vomiting serious?
Often it is not but persistent or severe symptoms may need medical evaluation.
When should I see a doctor for vomiting?
If it lasts more than a day, keeps you from staying hydrated or includes concerning symptoms.
Can stress cause vomiting?
Yes. Stress can affect the digestive system and trigger nausea or vomiting.
What helps stop vomiting at home?
Hydration, bland foods, rest and avoiding triggers can help.
