Vomit can exit through the nose, a phenomenon known as nasal regurgitation or nasal emesis. This occurs when the body’s protective mechanisms are overwhelmed or impaired.
How Your Body Normally Prevents Nasal Vomiting
The human body possesses sophisticated mechanisms to ensure that food and liquids, including vomit, travel through the intended pathways. During swallowing, a critical structure known as the soft palate, or velum, plays a central role. This muscular and tissue flap, located at the back of the roof of the mouth, elevates and makes contact with the back and sides of the throat (pharynx).
This movement effectively seals off the nasopharynx, which is the upper part of the throat connected to the nasal cavity. The coordinated muscle contractions of the soft palate and pharyngeal walls create a barrier, preventing ingested material from entering the nasal passages. This velopharyngeal closure is an essential reflex during normal eating, drinking, and forceful expulsion of vomit.
During vomiting, a complex series of events occurs, including deep breathing, closure of the glottis (the opening to the windpipe), and elevation of the soft palate to protect the nasal cavity. The diaphragm contracts sharply, and abdominal muscles vigorously squeeze the stomach, increasing intragastric pressure. With the pylorus (the opening from the stomach to the small intestine) closed and the esophagus relatively open, the primary exit route for stomach contents is through the mouth.
When Vomit Comes Through the Nose
Despite the body’s protective design, vomit can sometimes emerge through the nose when these mechanisms are compromised. One common reason is the sheer force of the vomiting reflex, particularly during forceful or projectile vomiting. The intense pressure generated can overwhelm the soft palate’s ability to completely seal off the nasal cavity, forcing some contents upwards.
Certain physiological states or medical conditions can also contribute. If the soft palate is relaxed or uncoordinated, such as during deep sleep, extreme gagging, or periods of altered consciousness, the protective seal might be incomplete. Conditions that affect the nerves and muscles involved in swallowing can impair the soft palate’s function, leading to nasal regurgitation. These include neurological disorders like stroke, cerebral palsy, Parkinson’s disease, or amyotrophic lateral sclerosis (ALS).
Structural abnormalities, such as a cleft palate (an opening in the roof of the mouth), can also directly lead to vomit entering the nasal cavity. Additionally, severe cases of postnasal drip, where excessive mucus drains from the sinuses down the throat, can sometimes induce vomiting. While less common, an obstruction preventing normal oral expulsion could theoretically redirect vomit nasally.
Addressing Nasal Vomit
When vomit comes through the nose, immediate steps can help manage discomfort. Gently clearing the nasal passages, such as by blowing the nose, can help remove residual vomit. Rinsing the mouth thoroughly is also advisable to address any lingering taste or acidity.
The highly acidic nature of stomach contents can irritate the delicate nasal lining, causing a burning sensation. To soothe this, gently flushing the nasal passages with a saline solution can be beneficial. Staying hydrated and avoiding highly acidic or spicy foods immediately afterward can also help prevent further irritation to the throat and nasal passages.
Nasal vomiting sometimes warrants medical attention. If it occurs frequently, is accompanied by other severe symptoms like difficulty breathing, chest pain, or significant distress, or if there are signs of dehydration, a healthcare provider should be consulted. Persistent or recurrent nasal regurgitation, especially without a clear cause like forceful vomiting, might indicate an underlying medical condition affecting swallowing function, such as a neurological issue or structural abnormality, and should be evaluated by a doctor.