The gastrointestinal system involves a series of complex processes and systems that turn food into energy and purge waste products from all around the body. These waste products usually make their way all the way through the digestive tract before being purged, but the body also has ways of ridding itself of harmful or irritating substances long before then. One of the ways it does this is through vomiting. Sometimes, though, the process of vomiting is especially violent and intense, and that is called projectile vomiting.

What Happens When I Vomit?

Vomiting, also technically referred to as emesis, is the involuntary expulsion of the stomach’s contents via the esophagus and mouth. In general, the impulse to vomit is a means of protection from potentially harmful substances that have been ingested. It can also be a reaction to something that is irritating the gastrointestinal tract in some way or a sign of an underlying health condition. In most cases, however, vomiting is an isolated albeit unpleasant incident that resolves once complete.

For most people, vomiting is usually preceded by a wave of nausea that may include an upset stomach, cold sweat, weakness, and a buildup of saliva in the mouth. Prior to actually vomiting, you may experience dry heaving, or retching, a reversal of movement in the stomach and esophagus that doesn’t move any substance out of the stomach. When vomiting occurs, it isn’t the stomach that pushes contents out; instead, the diaphragm and abdominal muscles contract and create the primary force of expulsion.

How is Projectile Vomiting Different?

Projectile vomiting is roughly the same phenomenon as non-projectile vomiting, though the force involved in expelling the stomach’s contents is much greater. This is also usually a reaction to something the body has identified as a toxin or an otherwise harmful substance. The greater force involved in projectile vomiting is strong enough to propel stomach contents several feet in front of you. The other notable difference between the two is that projectile vomiting tends not to be preceded by nausea; in many cases it comes on suddenly without any warning that it’s about to happen.

One specific form of projectile vomiting is called hypertrophic pyloric stenosis, but it is almost always limited to infants from birth to around six months old. In pyloric stenosis, there is a thickening or narrowing of the pylorus, the muscular sphincter at the base of the stomach where it connects to the small intestine. This thickening prevents food from moving into the small intestine; the stomach muscles attempt to force the food into the intestines but instead triggers projectile vomiting. Pyloric stenosis is one of the most common reasons newborns need surgery (pyloromyotomy), largely because of the danger of dehydration.

What Causes Projectile Vomiting?

There is no clear explanation for why the act of vomiting sometimes manifests as the much more forceful projectile vomiting. There are, however, several situations and conditions that seem more likely to cause projectile vomiting:

  • Food poisoning: Food poisoning is essentially an irritation of the stomach or other parts of the digestive tract by food or drink that is contaminated by bacteria like E. coli, vibrio, and salmonella. Such contaminants are not immediately detected, however, and it usually takes anywhere from a few hours to more than a day for any symptoms to appear. At that point the body triggers vomiting as a means of expelling the harmful bacteria. Food poisoning usually resolves on its own after a day or so.
  • Gastroenteritis: Also sometimes erroneously referred to as the stomach flu, gastroenteritis is an inflammation of the stomach or intestines by a virus or bacteria. The most common cause of gastroenteritis is the norovirus, which can be passed on through contact with another person or through food. Because of the tendency to cause vomiting, gastroenteritis can also lead to dehydration. Symptoms also include stomach pain, diarrhea, and fever.
  • Migraine: A migraine is a specific type of headache that seems to be caused by environmental factors and abnormal brain activity that affects brain chemicals, nerve signals, and blood vessels. It is thought that vomiting may be a way for the body to relieve some of the symptoms related to migraines by improving the neurotransmitter imbalance that lead to them.
  • Intracranial pressure: Intracranial pressure refers to an imbalance in some of the fluids inside the skull and brain tissue. It is thought that this kind of pressure can affect the part of the brain that actually triggers the impulse to vomit.
  • Pregnancy: Morning sickness is a common symptom of pregnancy that affects virtually all women, particularly during the first trimester. The name is something of a misnomer since nausea can happen at any time of day, but the vomiting related to that nausea is believed to occur because of changing levels of certain hormones.
  • Appendicitis: Appendicitis is an inflammation of the appendix, a small, tube-like projection on the colon that is believed to store beneficial gut bacteria. Symptoms include nausea, vomiting, abdominal pain, and a loss of appetite.

What Are the Complications of Projectile Vomiting?

In most cases, especially when vomiting is a reaction to a harmful substance, the experience is short-lived and will resolve itself. But in situations where projectile vomiting is associated with a specific illness or is recurring, there are several possible side effects or complications. The most common complication is dehydration, an overall loss of body fluid that results from not being able to keep food or water in the stomach. The signs of dehydration can include headaches, fatigue, dry mouth, constipation, and loss of appetite. In addition to the many dangers of not having enough water content in the body, the loss of electrolytes can further cause imbalances in cellular fluid content.

In rare situations, the violent and forceful nature of projectile vomiting may cause the esophagus to rupture. If untreated, this can be a fatal condition. Forceful vomiting can also cause damage to the lining of the stomach, which can cause a variety of issues with digestion. As vomit passes through the esophagus and out of the mouth, it is also possible for some of the vomit to be inhaled. This condition, called pulmonary aspiration, can cause a variety of problems, including pneumonia or asphyxiation.

Contact Cary Gastroenterology Today

Depending on the underlying cause, projectile vomiting can be a temporary annoyance or a significant concern. For most people, though, the symptoms related to vomiting can be treated at home by drinking fluids for rehydration purposes and eating bland foods or taking over-the-counter medications to address any nausea. If you have been experiencing vomiting or projectile vomiting more than as an isolated incident, it may be time to seek medical advice. If you’d like to speak with a gastroenterologist about your symptoms, please contact Cary Gastro today to request an appointment. We are passionate about providing excellent digestive healthcare for you and your family.