Projectile Vomiting

 What is Projectile Vomiting?

The expulsion or throwing up of undigested contents in the stomach from the mouth is known as vomiting. Projectile vomiting is condition in which expulsion occurs with a certain force and vomitus is expelled out of the body causing the contents of the stomach thrown out and spread over a considerable distance. In such cases, individuals do not feel nauseous, suffer from any gastric disorder or indigestion. In most cases, each attack involves excessive vomitus being passed out.

What Causes Projectile Vomiting in Babies & Newborns?

There is no need to panic as it is normal for babies to vomit. In case, baby vomits frequently and it leads to a loss of weight, a doctor must be consulted. Some common causes have been discussed below:

  • Obstruction – Food must reach the small intestine in order to be digested. Any kind of obstruction in the gastro intestinal system will prevent the food from entering the small intestine. In such cases, the food is forcefully thrown out of the system after remaining undigested in the stomach for a long time. Thus causing the contents of the stomach to be expelled with great force.
  • Pyloric stenosis – Pylorus muscles are the muscles present at the bottom of the stomach which is also the opening to the small intestine. When food is prevented from entering the small intestine due to the narrowing of the pylorus muscles, a condition of pyloric stenosis occurs causing projectile vomiting. Usually infants experience stomach contractions after feeding and the projectile spit up does not contain bile. However, complications such as fever, irritability and dehydration may be experienced.
  • Midgut volvulus – Sometimes while the baby is developing in the womb, the intestine might get twisted. This leads to an intestinal obstruction leading to projectile vomiting in infants. In this case, the vomit is accompanied with bile and sometimes it may also contain dark specs.

What Causes Projectile Vomiting in adults?

  • Stomach obstruction – Obstruction at the level of pylorus prevents the food from entering the small intestine through the stomach is known as gastric outlet obstruction. This leads to projectile vomiting containing bile.
  • Pressure on the brain – Conditions such as meningitis, stroke, brain tumor, and encephalitis cause pressure in the brain. Stomach contents are expelled in a violent manner due to the pressure on the brain.
  • Gastroenteritis – Inflammation of the gut caused due to infection from virus or bacteria is known as gastroenteritis. It causes diarrhea, abdominal cramping and projectile vomiting. Due to this nature of vomiting, the individual may get dehydrated too.
  • Cyclic vomiting syndrome – It is a scenario of repeated episodes of nausea and vomiting within a period of time due to stress, anxiety, motion sickness, etc. It includes projectile vomiting which may last from a few hours or few days. Dry heaving may also be experienced even after the stomach has been emptied of its contents.
  • Bowel obstruction – Bowel obstruction prevents the food from being properly digested. It causes abdominal cramps, excess gas, constipation and projectile vomiting. Bowel obstruction is a serious medical condition which may have severe consequences.
  • Food poisoning – Consumption of food that has been contaminated by bacteria contains toxins that can cause diarrhea, abdominal pain, fever and projectile vomiting.
  • Psychological causes – Conditions such as fear and stress may cause projectile vomiting. Other causes may include practices of purging in the fear of weight gain due to eating.

Rare Causes & considerations

  • Psychogenic causes: Extreme fear, anxiety or distress can also cause projectile vomiting. If the person has eaten a short while ago before experiencing high intensity of emotion, then there are higher possibilities.
  • Kidney problem: Blood composition and pH level could be affected due to kidney problems. Substances such as acids and urea in high quantities can stimulate the chemoreceptor trigger zone.
  • Shaken baby syndrome: Spinal cord injury or increase in intracranial pressure may be caused due to this syndrome.

Symptoms of Projectile Vomiting

In infants

  • Persistent hunger in babies after vomiting
  • Wave like stomach contractions in babies prior to vomiting
  • Emitting of milk to several feet
  • No wet diapers for several hours
  • Tummy appears swollen

In adults

  • Forced expulsion from mouth
  • Feeding is immediately followed by vomiting
  • Causes dehydration
  • Loss of weight
  • Vomitus is thrown over short distances
  • No signs of nausea
  • Sudden expulsion
  • Dry mouth
  • Lethargy
  • Bowel obstruction

Tests for Projectile Vomiting

  • Ultrasound scan to check for the presence of pyloric stenosis
  • Barium X-ray of the digestive system to examine small intestine
  • Examination of the pyloric muscle by gently pressing the stomach
  • Diagnosis for food poisoning
  • Blood tests to check the balance of electrolytes

Treatments for Projectile Vomiting

  • Allow the body to get rid of the toxins – If vomiting is due to overeating or excessive drinking, then it is best to let the body cleanse itself by expelling all the toxins. Unless all the unwanted matter is thrown out of the body, the individual cannot be healthy. Hence, it is best to allow the body to take its own course. It is advisable that the individual drinks enough fluids to be able to make up for the loss of electrolytes and prevent dehydration.
  • Medications – Food poisoning occurs when food has been affected by viral or bacterial infection. The toxins produced make the food unhealthy and humans suffer when they consume those food items. If a condition of food poisoning is diagnosed, certain medications should be prescribed to help in recovering. Substances that have antioxidant and anti inflammatory properties must be prescribed. Moreover, use of a proper antidote will help to get rid of the toxins that are causing illness.
  • Surgery – The only treatment for gastrointestinal blockages in infants is through Pyloromyotomy (surgery done to treat infants suffering from pyloric stenosis). It is a minimal invasive surgery which includes cutting of the outer layer of pylorus muscle to clear the blockage in the food channel. It is not complex and infants can be fed within a few hours after the surgery. More recent developments enable surgeons to conduct the surgery by making a minute incision on the baby’s navel by using a laparoscope. To avoid dehydration, vomiting children are put on intra venous fluids.

When to visit a doctor?

Vomiting is usually taken as a bodily response to waste matter or toxins in the body. It is most often understood as something that occurs and subsides in its own time. However, there are guidelines that have been marked according to certain conditions under which medical expertise is required. No matter how trivial a case of projectile vomiting may seem, neglecting such situations may have serious repercussions on the person’s health. Below mentioned are certain instances under which adults and infants suffering from severe vomiting must visit a doctor.

For infants/toddlers

  • Vomiting has not subsided for more than 2 days
  • Signs of dehydration such as – dry diapers, no tears while crying, etc. are observed
  • Vomiting is observed to contain black specks blood or if it is green in color
  • Excessive vomiting

For adults

  • Cramps in the abdomen
  • Vomit contains dark crumb like bits or blood
  • Vomiting along with sudden weight loss
  • Pain in the chest
  • Episodes of nausea and vomiting lasting for more than a month
  • Severe headache
  • Blurred or double vision

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