GastroIntestinal / Gastroenterology

What are the causes of projectile vomiting?

Projectile vomiting causes vomit to be forcefully sent out of the body. The causes of projectile vomiting in adults and infants are often different, and treatment varies depending on why it occurs.

Vomiting is classed as projectile if it is very sudden, and the vomit exits the body with some force. It may travel a few feet from the body.

This type of vomiting is often linked to the body trying to get rid of something harmful. This can range from a toxin, such as alcohol, to bacteria, for example, salmonella.

Fast facts on projectile vomiting:

  • The reasons for this kind of vomiting are not fully understood.
  • A person may have other symptoms, depending on the cause of the vomiting.
  • Projectile vomiting can lead to dehydration or malnutrition.

What is projectile vomiting?

senior women feeling sick holding hand over her mouth
Projectile vomiting is very sudden and happens without warning.

Projectile vomiting differs from regular vomiting in several ways:

  • the vomiting is more severe
  • the vomiting is forceful and travels
  • it happens without warning or feeling of nausea

The symptoms can include headaches, aches in the body, or lack of hunger. A study into projectile vomiting found that droplets from the vomit can travel a long way.

As a result, the illnesses that cause projectile vomiting can be highly contagious.


In infants

Projectile vomiting in infants is most often due to a condition called pyloric stenosis. This condition affects a tube in the child’s body that connects the small bowel and the stomach.

Pyloric stenosis makes it difficult for an infant to get enough nutrition and fluids. They can become dehydrated quickly, so it is important to seek medical attention urgently.

Symptoms of pyloric stenosis

Symptoms usually begin with vomiting a small amount of milk after feeding. This will gradually worsen over a few days until the infant begins to projectile vomit.

An infant with pyloric stenosis will not pee or poop as often as usual because they are not digesting food normally. Dehydration may make them seem more sleepy than normal or lacking in energy.

A doctor can diagnose the condition by feeling a lump in an infant’s belly. They will ask questions about feeding and may need to do an ultrasound scan.

Pyloric stenosis treatment

Treatment for pyloric stenosis is almost always surgery. This will widen the passage between the stomach and small bowel so that food can pass through and be digested.

The operation is carried out under general anesthetic. Once the operation is done, the infant will be given pain relief and fed with slowly increasing amounts of milk. When they are feeding normally, they can go home.

Surgery for pyloric stenosis is considered low-risk. There should be no long-term side effects.

In adults

Pyloric stenosis is rare in adults. Projectile vomiting in adults is more likely to be caused by an illness, a toxin, or food poisoning.

How is it different from normal vomiting?

woman washing hands
It is important for a person to wash their hands regularly if they have gastroenteritis.

Vomit from projectile vomiting is likely to have the same appearance and texture as that produced by regular vomiting.

However, projectile vomiting will often happen without warning and leave the body with force.

Regular vomiting and projectile vomiting normally have the same causes in adults, although projectile vomiting can be a sign that an illness is more severe.

How is it caused?

There are three key causes of projectile vomiting:

A person can get food poisoning if food is not prepared safely or has become infected by germs. Food can be contaminated with a virus, or a bacteria, such as salmonella, which is one cause of gastroenteritis.

Gastroenteritis can also be caused by a virus, such as norovirus. Norovirus is highly contagious and most common in the winter months.

Chemotherapy drugs, morphine, and alcohol are all classed as toxins, and they can all cause nausea and vomiting. In some cases, this may be projectile vomiting.

What are the treatments?

There is no specific medical treatment for gastroenteritis or food poisoning. A person should stay at home until they feel better. Treatments at home include:

  • rest
  • drinking plenty of fluids
  • taking painkillers to help with aches and fever
  • taking over-the-counter anti-vomiting medication
  • taking over-the-counter anti-diarrhea medication
  • eating small amounts of plain food, such as rice
  • using a rehydration drink if a person is dehydrated

Chewing on ice chips can help rehydrate and reduce any fever that may occur.

Gastroenteritis can pass from person-to-person easily. It is vital that someone with the illness washes their hands regularly to prevent the risk of it being spread. They should also try to avoid contact with people until 48 hours after symptoms have disappeared.

Other symptoms of food poisoning include belly pain, lack of energy, and fever.


Complications

man pouring water from jug into glass
Taking on fluids will help keep the body hydrated after vomiting.

Dehydration and malnutrition can happen when the body does not have enough fluids or food to keep working as normal.

In a small number of instances, projectile vomiting may cause a torn food pipe. The medical term for this is an esophageal laceration or Mallory-Weiss syndrome.

In these instances, the tear is usually caused by forceful or projectile vomiting.

One of the key symptoms of an esophageal laceration is blood in the vomit. In most cases, the bleeding is temporary and will stop without treatment.

If the bleeding continues or is severe, a doctor may need to do some tests. Treatment is usually with drugs or minor surgery to close a blood vessel.

Inhaling vomit can cause suffocation or choking. The acid in the vomit can also result in damage to the lungs if breathed in. A person who vomits while lying down should move onto their side to avoid this. Vomit should be cleaned up quickly and the mouth rinsed.


Outlook

Vomiting caused by food poisoning or gastroenteritis should last less than 1 week. Projectile vomiting caused by a toxin should stop once it is out of the system. The body’s way of getting rid of something harmful from the digestive system is often to vomit.

In infants, pyloric stenosis is usually resolved with surgery. The infant may vomit a small amount as their digestive system adjusts, but projectile vomiting should stop.

For both adults and children, projectile vomiting should have no long-term side effects. In some cases, the food pipe may be torn when vomiting. This is also resolved relatively easily and should not cause lasting damage.

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