Overview

If you’re vomiting greenish-yellow material, it could be bile. Bile is a fluid that’s made in your liver and stored in your gallbladder. It then travels to your small intestine, where it helps your body digest fats from foods.

Bile is made up of bile salts, bilirubin, cholesterol, electrolytes, and water.

Causes of throwing up bile

Reasons you might vomit bile include:

  • vomiting with an empty stomach
  • binge drinking
  • food poisoning
  • a blockage in your intestines

If you vomit bile more than once, a medical condition might be causing the problem. One common cause is bile reflux, which happens when bile backs up from your liver into your stomach and esophagus. You can develop reflux after gastric surgery.

Bile reflux is not the same as acid reflux. You get acid reflux when acid backs up from your stomach into your esophagus. Sometimes you can have both conditions together.

A blockage in your intestines can be due to:

  • Adhesions. These are areas of band-like scarring that can form in your intestines after abdominal or pelvic surgery.
  • Colorectal cancer and other cancerous tumors. These tumors can grow large enough to block part of the intestines.
  • Diverticulitis. This causes small pouches to form in the intestinal wall.
  • Hernia. This is a weakening in part of the intestine that causes it to bulge out into the abdomen or another part of the body.
  • Inflammatory bowel disease (IBD). Crohn’s disease and ulcerative colitis can cause inflammation in the intestine.
  • Volvulus. This is a twisting of the intestine.

Treatment options

The treatment for throwing up bile depends on what’s causing it. If you have food poisoning or you’ve been binge drinking, you may need to get intravenous fluids and electrolytes in the hospital.

If you have bile reflux, your doctor might start by prescribing one of these medications:

  • Ursodeoxycholic acid. This drug changes the composition of bile to help it flow more easily through your body. It can cause side effects like diarrhea.
  • Bile acid sequestrants. These drugs disrupt the circulation of bile. They can cause side effects like bloating.

If medications don’t control the problem, the next step might be surgery. Surgical options for treating bile reflux include Roux-en-Y gastric bypass. This procedure is also used to treat obesity. It creates a new connection to the small intestine to keep bile from draining into the stomach.

There are also surgical treatments for adhesions or a blockage in your bowel. Your doctor will remove the cause of the obstruction. They may also remove a piece of your intestine if it’s damaged. Another option is to place a wire mesh tube called a stent inside your intestine to keep the area open and relieve the blockage.

Colorectal cancer is treated based on how far the cancer has spread. Treatments can include surgery, radiation, chemotherapy, and targeted therapies.

Prevention

You can often lower your risk of vomiting bile by making certain lifestyle changes:

  • To lower your risk of vomiting from drinking, don’t drink more than one or two alcoholic beverages per day.
  • To lower your risk of colorectal cancer, eat lots of fruits and vegetables, don’t smoke, and get screened with a colonoscopy or other test if you’re 50 or over.
  • To lower your risk of developing a hernia, don’t lift objects that are too heavy.
  • To lower your risk of diverticulitis, eat a high-fiber diet.

When to call your doctor

Call your doctor if you’re throwing up bile and have symptoms of reflux.

Get medical help right away if you’re:

  • losing weight without trying
  • having chest pain
  • having trouble breathing
  • having severe pain in your abdomen
  • vomiting up material that is red or that looks like coffee grounds
  • unable to stop vomiting

Outlook

Your outlook depends on what’s causing you to throw up bile. If the cause is food poisoning or binge drinking, the symptom should go away on its own. Avoiding excess alcohol or contaminated foods can help ensure that it doesn’t happen again.

A bowel obstruction can become serious — very quickly in some cases — if you don’t treat it. It can lead to pockets of infection, called abscesses, in the intestines. Another risk is a blood infection called sepsis. Surgery can relieve the blockage and prevent these complications.

The outlook for colorectal cancer depends on the stage of the cancer and how it’s treated. If the cause is IBD or diverticulitis, treatment should help.