Vomiting bile, a yellowish-green, bitter fluid, can be unsettling. Understanding its causes and the body’s processes can help. This article explains what bile is, how the body handles it, reasons for vomiting it, and when to seek medical attention.
Understanding Bile and the Vomiting Process
Bile is a digestive fluid produced by the liver, playing a significant role in fat digestion. It is stored and concentrated in the gallbladder, a small organ beneath the liver. After a meal, especially one with fats, the gallbladder releases bile into the duodenum, the first part of the small intestine, to break down dietary fats, aiding their absorption.
Vomiting is a reflex coordinated by the brain’s vomiting center, involving the diaphragm and abdominal muscles. When triggered, stomach muscles contract, and the diaphragm and abdominal muscles press upward, expelling stomach contents. Bile is found further along the digestive tract in the small intestine. Its presence in vomit usually indicates an empty stomach or significant backflow from the small intestine.
Common Reasons for Vomiting Bile
Vomiting bile often indicates an empty stomach. A common scenario is vomiting on an empty stomach, where no food remains to expel, leading to the body drawing up digestive secretions like bile. This can happen after prolonged periods without eating or following persistent nausea.
Bile reflux is another frequent cause, where bile flows backward from the small intestine into the stomach and sometimes the esophagus. This can result from issues with the pyloric valve, which controls flow between the stomach and small intestine, or as a complication of gastric surgery or gallbladder removal. Peptic ulcers can also obstruct the pyloric valve, contributing to bile reflux.
Intestinal blockages, or bowel obstructions, are a major cause of vomiting bile as they prevent the normal passage of contents through the digestive tract. This backup forces bile and other fluids into the stomach, leading to their expulsion. Conditions like gastroenteritis or food poisoning can also lead to prolonged vomiting, eventually emptying the stomach and causing bile to be vomited.
Excessive alcohol consumption can cause vomiting, which may irritate the stomach lining. After stomach contents are expelled, continued retching can bring up bile, especially if alcohol was consumed on an empty stomach. Morning sickness during pregnancy, particularly severe forms like hyperemesis gravidarum, can also cause persistent vomiting that includes bile.
When to Seek Medical Attention
While occasional vomiting of bile is not always serious, certain symptoms warrant prompt medical evaluation. Seek medical attention if vomiting bile is persistent, occurs frequently, or is accompanied by severe symptoms.
Specific symptoms warranting medical care include severe abdominal pain or cramping, chest pain, and difficulty breathing. The presence of blood in the vomit, appearing bright red or like coffee grounds, also requires immediate attention. Signs of dehydration, such as excessive thirst, dry mouth, infrequent urination, dizziness, or lightheadedness, indicate a need for professional assessment. A high fever, stiff neck, confusion, or unexplained weight loss combined with vomiting bile are also reasons to consult a doctor.