Vomiting is a common symptom of motion sickness, morning sickness, or gastroenteritis — an inflammation of the stomach and intestines caused by an infection, such as the stomach flu or food-borne illness. This symptom may also be caused by excessive alcohol intake or certain medications, most notably chemotherapy drugs.
While persistent vomiting or severe dehydration requires medical intervention, mild vomiting is often managed at home, with the priority of replacing fluids and electrolytes to prevent or treat dehydration. Resuming solid foods is not as critical as fluid replacement, and a transition back to a normal diet can begin as the vomiting resolves and the appetite returns.
After throwing up, fluid replacement is essential to counter and prevent dehydration — the most common complication of vomiting. After a single episode of vomiting, when dehydration symptoms such as dry mouth or reduced urine production are not yet present, adults can consume clear liquids such as water, broth, diluted fruit juices or weakly sweetened tea to replenish their body of lost fluids.
Undiluted fruit juice and most other sugar-sweetened drinks are not recommended, as the sugar concentration in these beverages may lead to cramping or diarrhea. Adults can also use sports drinks, however, they are not considered to be more advantageous than other clear liquids.
Oral Rehydration Solutions
In adults who have ongoing vomiting or dehydration, or in any children who are vomiting, the best beverage choice is an oral rehydration solution (ORS), such as Pedialyte, Infalyte or Rehydrate. These drinks aid in recovery by providing the optimal concentration of sugars and certain electrolytes, including sodium, potassium and bicarbonate.
ORS use in children is particularly important, and recommended, since dehydration and electrolyte loss in children can more quickly escalate to a serious situation. Hydration guidelines, as outlined in the June 2012 issue of "American Family Physician," recommend initiating frequent, small sips of ORS within 10 to 60 minutes of vomiting, although infants who are breastfed or formula fed should continue their current feeding plan and not use ORS.
When fluids are tolerated and vomiting is no longer a current threat, solid foods may be resumed. However, diet choices do not need to be restrictive after throwing up.
Traditionally, bland foods have been recommended — most notably the BRAT diet, which stands for bananas, rice, applesauce and toast. While these foods — and other comfort foods such as broth-based soup, soft fruit, potatoes, hot cereal, or crackers — may work well for the first solid foods after vomiting, there is no demonstrated benefit from this diet approach.
Also, following the BRAT diet for more than a meal or two is considered too restrictive and does not provide optimal nourishment for recovery. Instead, as symptoms subside, a gradual transition back to normal foods, including fruits and vegetables, is recommended.
While most cases of vomiting resolve within the same day, sometimes medical attention is needed. Severe, life-threatening dehydration is a significant risk in sick children.
A pediatrician should be consulted for advice on home management of vomiting, and urgent medical attention should be sought if vomiting persists, if the child is unwilling or unable to drink ORS, or if dehydration symptoms are still present after 24 hours of ORS treatment.
Adults should also seek medical care if they have persistent vomiting, if unable to drink more than a few sips of liquid, or if they have signs of severe dehydration such as cracked lips, little or no urine output or severe weakness.
Also, medical attention is recommended with symptoms of abdominal swelling, ongoing pain or tenderness, blood in the vomit, or if the vomiting accompanies a recent head injury, a headache, stiff neck or confusion.
Reviewed by Kay Peck, MPH RD
Is This an Emergency?
- American Academy of Pediatrics: Treating Vomiting
- American Family Physician: Gastroenteritis in Children: Part II. Prevention and Management
- Merck Manual: Overview of Gastroenteritis
- Merck Manual: Nausea and Vomiting in Adults
- Centers for Disease Control and Prevention: Managing Acute Gastroenteritis Among Children