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What to Know About Projectile Vomiting in Adults

Medically Reviewed by Dan Brennan, MD on May 01, 2021

Vomiting is something that everyone will experience at some point. It’s typically accompanied by a wave of nausea, and a queasy feeling in the stomach afterward. ‌

Projectile vomiting is when your body expels vomit with more force than usual. It’s one of your body’s reactions to something it recognizes as toxic, but there are medical conditions that can cause projectile vomiting as well. 

What Is Projectile Vomiting?

Nausea and vomiting are general symptoms, and they often come as a set. A general symptom means there’s no one illness or condition that causes that symptom. Both nausea and vomiting could indicate a range of issues, stemming from physical or even mental or emotional causes.

Vomiting is when you expel the contents of your stomach. Projectile vomiting is different due to two main factors. 

  1. Regular episodes of vomiting are often preceded by a wave of nausea. Projectile vomiting can come on suddenly, without any signs that it's about to happen. 
  2. Projectile vomit is expelled with much more force than regular vomit. It’s even been recorded to reach a distance of 1.2 meters, or almost four feet. 

What Causes Projectile Vomiting?

Vomiting is something that can turn most people’s stomachs, but it does serve a purpose. Our body is sensing that something is bad for us, and needs to remove it. Some cases of projectile vomiting happen because you’ve ingested something toxic, so the body purges itself to keep you healthy. Other times, projectile vomiting can be caused by a virus or problem with the nervous system. Some causes include: ‌

Food poisoning. Food poisoning happens when you eat food that’s been contaminated with harmful germs. Several different types of bacteria and viruses can cause food poisoning. Some of the most well-known are Staphylococcus aureus, salmonella, and E.coli

Your body usually detects these invaders within 2-12 hours of ingestion and could start to expel the contents of your stomach within that time frame.

Toxins. These are different than bacteria and viruses, and are found in things people typically aren't supposed to eat, such as inedible mushrooms or spoiled food. The time they can take to affect you can range from a few hours to 1-2 days. It depends on the kind you ingest. You may have heard of botulism, which is a dangerous toxin.

Infections. Some viral infections can cause projectile vomiting. Norovirus is one example. It’s easily spread from person to person through contact with droplets and feces. Since projectile vomit can reach up to four feet, the droplets can also spread that far to contaminate others.

Intracranial pressure. This is when your brain presses against the inside of the skull, causing various effects within the body. It is often tied to other medical conditions, and may induce projectile vomiting and severe headaches upon waking up from sleep.

Complications of Projectile Vomiting

Most cases of projectile vomiting are short-lived, but extended sickness and vomiting can cause complications. 

Dehydration is the most common problem associated with all vomiting, but especially with this forceful type. It can happen when your stomach is expelling its contents and you’re unable to hold anything down. With this combination, the body is unable to get liquids and will dehydrate.‌

Forceful vomiting, in some rare cases, can cause your esophagus to rupture. It can also be damaging to the lining of your stomach.

If an individual inhales the vomit, which is called aspiration, this too can create a variety of problems.  

Treatment of Projectile Vomiting

Dehydration due to projectile vomiting can usually be treated easily. Drink small amounts of clear liquids. Start drinking only 30 minutes after the last bout of vomiting.‌

Drinking broth or weak tea can also help. Sports drinks don’t seem to provide any extra effect, good or bad, so drink them carefully if your body can tolerate them. Once you can keep small amounts of liquid down, the next step is food.

Reach for the BRAT diet, or foods that are bland and starchy, to help settle your stomach. BRAT is an acronym for: 

  • Bananas 
  • Rice
  • Applesauce
  • Toast

The main idea is to eat bland, starchy foods until you’re ready to eat regular meals again. The BRAT diet isn’t meant for long term use, but for the 24-48 hour period after nausea or vomiting.

If you’re suffering from nausea, your doctor might recommend some anti-nausea medication to relieve your symptoms.   

If you think you might be projectile vomiting due to intracranial pressure, your doctor can perform a brain computed tomography test, or CT scan, to learn further. 

When to See a Doctor

Most viruses pass within a short period of time. Call your doctor if: 

  • Your symptoms last longer than a few days
  • You can’t keep liquids down
  • You have a fever
  • Your stools are bloody
  • You have severe or long-lasting diarrhea
  • You miss prescription medication due to stomach intolerance

Show Sources

SOURCES: 

American Family Physician: “Evaluation of Nausea and Vomiting in Adults: A Case-Based Approach.”

‌ATSU: “NONINFLAMMATORY GASTROENTERITIS - FOOD POISONING.”

‌CDC: “How Norovirus Spreads.”

Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition: “Chapter 84Nausea and Vomiting.”

‌FamilyDoctor.org: “BRAT Diet: Recovering From an Upset Stomach.”

‌FoodSafety.gov: “Bacteria and Viruses.”

Journal of Infection Prevention: “Vomiting Larry: a simulated vomiting system for assessing environmental contamination from projectile vomiting related to norovirus infection.”

Merck Manual: “Nausea and Vomiting in Adults.”

‌Reliant Medical Group: “Is it a Stomach Virus or Food Poisoning?”

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