It is medically possible to vomit fecal matter, a phenomenon known as stercoraceous vomiting or feculent vomiting. This occurrence is not a standalone condition but a serious symptom indicating a significant underlying medical problem. It signals that the normal one-way flow of the digestive system has been severely disrupted. This event always requires immediate medical attention due to its serious health implications.
Understanding Fecal Vomiting
Fecal vomiting involves the expulsion of fecal material through the mouth. This occurs when the digestive tract is blocked, preventing the normal passage of digested contents. Instead of moving downward, material backs up into the stomach and is then vomited.
The vomit often has a distinct fecal odor and may appear brownish or dark in color, reflecting contents of the lower digestive tract. The body’s natural muscular contractions, called peristalsis, attempt to push the blocked contents backward, leading to their expulsion.
Primary Causes
Fecal vomiting results from various types of bowel obstructions, where a physical blockage or a functional issue prevents the normal movement of intestinal contents. Mechanical intestinal obstructions are common, often occurring in the small bowel. These blockages can arise from several factors, including:
Adhesions or scar tissue formed after previous abdominal surgeries.
Hernias, where a part of the intestine protrudes through a weak spot in the abdominal wall.
Tumors or growths within the intestines that physically block the passage of material.
Inflammatory bowel diseases like Crohn’s disease, which can cause strictures or narrowing of the bowel.
Volvulus, a twisting of the intestine.
Intussusception, where one part of the intestine telescopes into another.
Paralytic ileus, a condition where intestinal muscles stop functioning properly without a physical blockage, mimicking an obstruction.
Accompanying Symptoms
Several other serious symptoms accompany the underlying conditions that cause fecal vomiting. These include:
Severe abdominal pain, often described as cramping or colicky, which may come and go in waves.
Abdominal distension and bloating due to the buildup of gas and fluid.
An inability to pass gas or stool, indicating a complete or near-complete blockage.
Nausea, almost always present before vomiting episodes.
Dehydration, which can quickly develop due to fluid loss from vomiting and reduced fluid intake, leading to dry mouth, decreased urination, and lightheadedness.
A general feeling of malaise, weakness, and fatigue.
When to Get Medical Help
Fecal vomiting is always a medical emergency and requires immediate attention. Anyone experiencing this symptom should seek emergency medical care without delay, such as calling emergency services or going to the nearest emergency room. This symptom signals a severe problem within the digestive system that can rapidly lead to life-threatening complications.
Delaying treatment can result in serious outcomes, including bowel perforation, where a hole forms in the intestinal wall, leading to leakage of contents into the abdominal cavity. This can cause peritonitis, a severe infection and inflammation of the abdominal lining, and can progress to sepsis, a life-threatening response to infection that can lead to organ failure. Prompt medical intervention is necessary to identify and address the underlying cause and prevent these complications.
Medical Interventions
Upon arrival at a medical facility, healthcare professionals diagnose the cause of fecal vomiting through a series of assessments. A physical examination assesses abdominal tenderness, distension, and bowel sounds. Imaging studies are used, with X-rays often being the initial step to identify signs of obstruction, such as dilated loops of bowel or air-fluid levels.
Computed tomography (CT) scans provide more detailed images, helping to pinpoint the exact location and cause of the blockage. Blood tests are also performed to evaluate for signs of infection, dehydration, and electrolyte imbalances. Initial treatment often includes intravenous fluids to address dehydration and electrolyte abnormalities, and pain management. A nasogastric tube may be inserted through the nose into the stomach to decompress it and remove backed-up contents, providing relief. Surgical intervention is frequently required to relieve the obstruction, especially in cases of mechanical blockage, with the specific procedure depending on the underlying cause.