Can a person truly vomit fecal matter? The direct answer is no, not in the sense of expelling formed stool from the large intestine. However, a serious medical condition known as “feculent vomiting” or “stercoraceous vomiting” can occur, where the vomited material has a fecal-like appearance and odor. This symptom indicates underlying digestive system dysfunction and requires immediate medical attention.
Understanding Feculent Vomiting
Feculent vomiting involves the expulsion of material originating from the small intestine, not the large intestine. Normally, digestive contents move forward through the intestines. When this process is disrupted, contents can back up. The vomited material consists of partially digested food, bile, and intestinal secretions that have stagnated in the small intestine.
The characteristic appearance of feculent vomitus is often dark and brownish, with a distinctly foul, fecal-like odor. This smell arises from the bacterial decomposition of the backed-up intestinal contents. The presence of such material indicates a significant problem within the digestive tract.
Common Causes
Feculent vomiting is a symptom of conditions that obstruct the normal flow of material through the intestines. The most common cause is a mechanical intestinal obstruction, where a physical blockage prevents contents from moving forward. This can result from adhesions or scar tissue, often forming after abdominal surgeries, or from hernias where a part of the intestine protrudes. Tumors or growths within or pressing on the intestines, as well as a twisting of the bowel known as volvulus, can also create such blockages.
Another cause is paralytic ileus, a functional problem where the intestinal muscles temporarily stop moving, even without a physical obstruction. This can occur after abdominal surgery, due to certain medications like opioids, electrolyte imbalances, or infections. The lack of muscle contractions leads to a buildup of fluid and gas, mimicking a blockage.
Gastric outlet obstruction, a blockage at the exit of the stomach, can also lead to feculent vomiting if severe and prolonged. A rarer cause is a gastrocolic fistula, an abnormal connection between the stomach and the colon, which allows colonic contents to enter the stomach and be vomited.
When to Seek Medical Attention
Experiencing feculent vomiting is a medical emergency that warrants immediate professional evaluation. Anyone exhibiting this symptom should seek urgent medical attention, typically by calling emergency services or going to the nearest emergency room. Prompt care is necessary to diagnose the underlying cause and prevent serious complications.
Potential complications include severe dehydration and electrolyte imbalances due to persistent vomiting. There is also a risk of aspiration pneumonia, which occurs if vomited material is inhaled into the lungs. If the cause is an intestinal obstruction, delayed treatment can lead to tissue death in the affected bowel segment or a tear in the intestinal wall, which can be life-threatening. Other concerning symptoms that require immediate medical attention alongside vomiting include severe abdominal pain, high fever, or confusion.