Projectile vomiting is a type of severe vomiting in which stomach contents can be forcefully propelled several feet away from you. It usually comes in shorter, more violent bursts than other types of vomiting. It’s also more likely that projectile vomiting will come on suddenly with little or no warning instead of coming after you’ve felt nauseous for a while.

Read on to learn more about this type of vomiting and when you should seek help.

Projectile vomiting in infants and children has several potential causes:

Pyloric stenosis

Pyloric stenosis is a thickening of the muscle where the stomach empties into the small intestine. It usually causes symptoms within three to five weeks after birth, and it blocks food from moving from the stomach to the duodenum of the small intestine.

Pyloric stenosis requires surgery because malnourishment, dehydration, and growth failure will occur if it’s allowed to continue.

Other symptoms include:

  • fewer and smaller bowel movements
  • failure to gain weight or weight loss
  • dehydration
  • a ripple of contractions in your baby’s stomach after feeding

Reflux

Reflux is a condition in which stomach contents back up into the esophagus. In more severe cases, a reflux of acid from the stomach causing esophageal irritation, known as gastroesophageal reflux disease (GERD), can cause projectile vomiting.

Other symptoms of GERD in infants include:

  • spitting up yellow or green fluid
  • difficulty breathing
  • refusing food

Stomach obstructions

Other stomach obstructions besides pyloric stenosis can also cause projectile vomiting. For example, if your child swallows a small object, it can block their stomach from emptying.

Infection

Infections, such as that due to a virus, are a common cause of vomiting in children. While most don’t cause projectile vomiting, it’s possible. Stomach or intestinal infections in children have similar symptoms as those seen in adults, including diarrhea, fever, and abdominal cramps. They typically can be treated in the same way as well, with time, rest, rehydration, and bland foods.

Overeating

Overeating can sometimes lead to projectile vomiting, as the stomach tries to expel food it doesn’t have room for.

When to call your child’s doctor

Projectile vomiting in infants requires medical care, no matter the cause. If an older child has been projectile vomiting for more than 24 hours, call their doctor. You should also call their doctor if they have projectile vomiting along with bloody stool or severe stomach pain, or their vomit has blood in it or looks green.

There are several possible causes for projectile vomiting in adults, as well.

Infection

Infections of the gastrointestinal tract, such as from norovirus, are responsible for most cases of vomiting in adults. This is sometimes referred to as the stomach flu. While projectile vomiting is not common with these types of infections, it’s possible.

In addition to vomiting, symptoms of a gastrointestinal infection may include:

  • abdominal pain
  • diarrhea
  • body aches
  • fatigue

Food poisoning

Food poisoning can also cause projectile vomiting. This is because your body is trying to get rid of the toxin, such as a bacterium, that was contaminating the food. Learn how to tell if it’s a stomach bug or food poisoning.

Obstructions

Stomach or bowel obstructions have many causes in adults, and such obstructions can cause projectile vomiting. Obstructions can be caused by:

  • twisting of the intestine (intestinal volvulus)
  • adhesions
  • hernias
  • noncancerous and cancerous tumors

Other symptoms of obstructions include:

  • severe bloating and pain
  • constipation or diarrhea, depending on how much your bowel is obstructed
  • decreased appetite

Overeating

Overeating can lead to projectile vomiting in adults, as the stomach tries to expel food it doesn’t have room for.

When to call your doctor

You should call your doctor if you have:

  • severe abdominal pain
  • blood in your vomit or stool
  • projectile vomiting that lasts for more than 24 hours

Projectile vomiting is usually harmless, but these are signs of a more serious issue.

Vomiting is your body’s way of expelling something that it thinks is harmful. This means that the best way to treat projectile vomiting in children and adults is just to wait until it’s done.

Once your episode of projectile vomiting is over, there are things you can do to take care of yourself. Vomiting can make you dehydrated, so it’s important to drink water or a drink with electrolytes, such as Gatorade, as soon as you can keep it down.

Once you can keep liquid down, you should also try to eat. It’s a good idea to start with small amounts of blander foods, such as dry toast, bananas, broth, rice, applesauce, or crackers. This is known as the BRAT diet. Don’t force yourself to continue eating if you start to feel nauseous. However, once you’re able to tolerate the bland solid foods, trying to work back to a balanced full diet sooner is better than later, if possible.

In infants

Treatment for infants who are projectile vomiting depends on the cause. If pyloric stenosis is causing the vomiting, surgery is necessary to widen the pyloric channel and allow food to empty out of the stomach to the small intestine normally.

If GERD is causing your baby’s projectile vomiting, feeding them more frequently and with less food at a time can help. Frequent burping and making sure your baby stays upright for 30 minutes after feeding can also help reduce reflux.

Projectile vomiting caused by a bacterial infection might require an antibiotic or might just require time to go away.

The main potential complication of projectile vomiting, like with other types of vomiting, is dehydration. You can treat or prevent dehydration by drinking water or a sports drink as soon as you can keep it down after vomiting. You may also try sucking on ice chips. That can help keep you hydrated while controlling the amount of liquid you’re ingesting.

Chronic vomiting can also lead to malnutrition and weight loss because your body is expelling food instead of digesting and absorbing nutrients from it. Slowly reintroducing bland foods after vomiting can help you keep food down and avoid these complications.

Projectile vomiting is more forceful than other types of vomiting, so it’s more likely to lead to esophageal tearing. A tear in the esophagus’s superficial inside lining (mucosa) near where it meets the stomach is called a Mallory-Weiss tear. If you have blood in your vomit and abdominal pain after an episode of severe vomiting, you should call your doctor. They can diagnose a tear using an upper GI endoscopy to look at your lower esophagus. Many times this will heal on its own, but a doctor can fix the tear if necessary.

Projectile vomiting is often no more harmful than other types of vomiting, but it may be a sign of more serious issues, especially in infants and children. If your infant is projectile vomiting, you should always call their doctor. You should call your doctor if you or your child is projectile vomiting and has severe abdominal pain, blood in vomit or stool, or if projectile vomiting lasts for more than 24 hours. Otherwise, the best things you can do are rehydrate after you’ve finished vomiting and introduce foods slowly.