Vomiting fecal matter, medically known as feculent vomiting or copremesis, is possible. This occurrence is a serious indicator of an underlying health problem, typically a significant blockage within the digestive system. Understanding its mechanisms and recognizing associated symptoms are important for comprehending its severity.
How the Body’s Plumbing Works
The human digestive system is designed for a one-way flow, moving food and waste from the mouth through the esophagus, stomach, and intestines, eventually exiting as stool. This intricate system relies on coordinated muscle contractions, known as peristalsis, to propel contents forward. When this normal passage is disrupted by a significant obstruction, the system’s “plumbing” can back up.
A blockage prevents the downward movement of digested material, gas, and fluids. As these contents accumulate behind the obstruction, pressure builds within the intestines. This increased pressure can eventually force the intestinal contents, including fecal matter, to reverse direction and be expelled through the mouth as vomit.
Common Causes of Blockage
Feculent vomiting most commonly results from an intestinal obstruction, where a physical barrier prevents the normal flow of digested material. Abdominal adhesions, which are bands of scar tissue often formed after previous surgeries, are a leading cause of small bowel obstruction in developed countries, accounting for a significant percentage of cases. These adhesions can constrict or twist the intestine, creating a blockage.
Other common causes of intestinal obstruction include:
Hernias: A segment of the intestine protrudes through a weakened abdominal wall and becomes trapped.
Tumors: Both cancerous and non-cancerous growths can physically block the intestinal passageway.
Inflammatory bowel diseases (IBD): Conditions like Crohn’s disease can cause chronic inflammation and scarring, narrowing the intestinal lumen.
Diverticulitis or Volvulus: Inflamed pouches (diverticulitis) or twisted bowel sections (volvulus) can also cause blockages.
Beyond the Vomit: Other Signs
Feculent vomiting is rarely an isolated symptom and accompanies other signs of a severe intestinal blockage. Individuals often experience intense abdominal pain, which can manifest as cramping that comes and goes in waves, or eventually become constant. This pain is frequently accompanied by significant abdominal distension, where the abdomen appears swollen due to the buildup of gas and fluids.
A distinct symptom of an intestinal obstruction is the inability to pass gas or have a bowel movement, especially in cases of complete blockage. Nausea is a common precursor to the vomiting, and ongoing vomiting can lead to dehydration, presenting with symptoms like a rapid heartbeat or dark-colored urine. These symptoms require prompt medical attention.
When to Seek Immediate Help
Feculent vomiting necessitates immediate hospitalization. The underlying intestinal obstruction can lead to serious, life-threatening complications if not addressed quickly. One such risk is the cutting off of blood supply to a section of the intestine, known as strangulation, which can cause tissue death within hours. This tissue death can result in a perforation, or tear, in the intestinal wall. This allows intestinal contents to leak into the abdominal cavity, causing severe infections like peritonitis or sepsis, both of which can be fatal.
Upon arrival at the hospital, medical professionals will work to stabilize the patient. Diagnosis typically involves a physical examination, medical history, and imaging studies like abdominal X-rays or computed tomography (CT) scans to confirm the obstruction’s presence and location.
Treatment often includes intravenous fluids for dehydration and electrolyte imbalances. A nasogastric tube may be inserted through the nose into the stomach to decompress the gastrointestinal tract by suctioning fluids and gas. While some partial obstructions may resolve with non-surgical management, complete obstructions often require surgical intervention to remove the blockage and any damaged sections of the intestine. Attempting self-treatment for such a severe condition is not an option.