If you’ve caught an intestinal flu and the vomiting seems relentless, how do you know when a trip to the emergency room is necessary? Gastroenterologist Christine Lee, MD, offers some advice, saying GI issues like vomiting are common with wide ranges in causes.
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“Potential causes very widely with long list of possible explanations” she says.
Dr. Lee adds that there are limitations with trying to find the cause for vomiting over the phone, but some classic alarm features to ask for when determining if an emergency room visit is necessary are if you’re unable to keep anything down, your symptoms escalate or you experience any of the following:
- Chest pains.
- Shortness of breath.
- Lethargy or a change in mental alertness.
How to treat vomiting at home
Vomiting can be caused by an infection (stomach flu) or a mild case of food poisoning.
To treat it:
- Hydrate by drinking clear liquids.
- Avoid solid food until the vomiting ends.
- Get extra rest.
- Temporarily stop taking all non-essential oral medications, health supplements and over-the-counter medications which may irritate the stomach and make vomiting worse.
However, if the vomiting fails to improve or resolve, you may need to seek medical help, as it could be a sign of other issues. If you’re experiencing an extended period of vomiting and dehydration becomes a concern, you may need to seek medical attention.
When to visit the emergency department
For the most part, if you have uncontrolled vomiting for extended periods of time where you can’t keep anything down, you should go to the emergency room. This is especially true for the very young, the elderly, or those with severe underlying health conditions, Dr. Lee says.
“The young and the old are more susceptible to complications from dehydration,” she says. “They are more vulnerable to kidney failure or electrolyte imbalances that can become serious.”
There are several questions a doctor on call will ask (and you can ask yourself) in determining what the cause might be, as well as the most prudent course of action, Dr. Lee says.
Ask yourself these questions to see if you should visit the emergency room:
- Are you vomiting blood? If the amount of blood is significant, Dr. Lee says you should go to the emergency room to rule out upper gastrointestinal bleeding.
- Are you also experiencing diarrhea, or bloody diarrhea? Dr. Lee says that can sometimes indicate indicate an outbreak of food poisoning, which can lasts longer than 24 hours. “Salmonella and certain E. coli strains can be more serious if prolonged,” Dr. Lee says. Doctors can also rule out colitis, inflammatory bowel disease or acute diverticulitis, she says.
- Was it something you ate? There’s no way to know for certain, but if you have friends or family members you recently saw who are also ill “that lends itself to an infectious cause,” she says. “If everyone who ate at a picnic all falls ill with same symptoms, it’s more than likely to be food poisoning,” says Dr. Lee.
- Can you keep down clear fluids? If not, the inability to tolerate any clear liquids by mount or keep anything down is a warning sign that medical attention may be needed,” she says.
- Do you have a fever? “That makes doctors think it’s more likely to be an infection, although certain illnesses such as Crohn’s disease or neoplastic syndromes can bring on fevers,” Dr. Lee says. Fevers are less likely to happen if the cause is just acid reflux or peptic ulcer disease, she says.
- Do you have other significant symptoms? Dr. Lee says other red flags include intense escalating abdominal pain, lethargy and mental confusion. “Those are big red flags,” she says, “need to seek immediate medical attention”
Use these questions to help you identify red flags — reasons to visit an ER for vomiting rather than riding it out. If you are ever in doubt, call your doctor.