Fecal vomiting, medically termed copremesis or stercoraceous vomiting, is the expulsion of material originating from the bowels through the mouth. It is a serious medical symptom that requires immediate attention. Understanding its characteristics and causes is important for prompt medical intervention.
The Appearance of Fecal Vomit
Fecal vomiting typically presents with distinct characteristics in color, consistency, and odor. The vomited material often appears dark brown or greenish-brown, resembling actual stool. Its consistency can vary from thick and paste-like to more watery with particulate matter, depending on the specific contents and the duration of the underlying issue. A strong, unpleasant, and distinctively feculent odor is a hallmark of this type of vomit.
The precise appearance can sometimes offer clues about the location of the problem within the digestive tract. If the obstruction is lower in the digestive system, the vomited material is more likely to closely resemble formed feces. In cases of small bowel obstruction, the vomit might initially be bilious (greenish-yellow) and progress to a brown, feculent appearance as the contents back up.
Medical Reasons for Fecal Vomiting
Fecal vomiting primarily results from conditions that prevent the normal forward movement of waste through the intestines. The most common cause is an intestinal obstruction, a physical blockage halting digestive contents. This blockage can occur in either the small bowel or the large bowel. Small bowel obstructions are frequently caused by adhesions (scar tissue from previous surgeries), hernias, tumors, or conditions like intussusception (where one part of the intestine telescopes into another).
Large bowel obstructions can stem from factors such as colon cancer, diverticulitis, volvulus (twisting of the bowel), or severe fecal impaction. When an obstruction occurs, the body’s natural muscular contractions (peristalsis) attempt to push the contents forward, but with a blockage, these contents are forced backward, leading to vomiting. Less common causes include a gastrocolic fistula, an abnormal connection between the stomach and the colon, allowing colonic contents to enter the stomach. Another cause is severe ileus, a condition where the intestinal muscles lose their ability to contract properly, leading to a functional blockage without a physical obstruction.
When to Seek Immediate Medical Care
Fecal vomiting is a medical emergency requiring immediate attention. Individuals experiencing this symptom should call emergency services or go to the nearest emergency room without delay. Prompt diagnosis and treatment are important to prevent severe complications. Complications include dehydration, electrolyte imbalances, and infection.
Untreated intestinal obstructions can lead to severe issues like bowel perforation (a hole in the intestinal wall) or sepsis, a life-threatening bloodstream infection. Diagnosis typically involves a physical examination and imaging tests like X-rays or CT scans to identify the location and nature of the obstruction. Rapid medical intervention improves outcomes.