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What is Intractable Vomiting?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 20 September 2016
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Intractable vomiting is repeated vomiting that resists medical treatment. People can develop this symptom for a number of reasons and treatment is focused on providing supportive care to keep the patient as comfortable as possible until the cause can be resolved. There are some risks associated with intractable vomiting, including dehydration and the possibility of a hiatal hernia, where part of the stomach slips through the diaphragm and into the upper chest. Care for intractable vomiting can be supervised by a general practitioner or a specialist, depending on the cause.

In people with intractable vomiting, repeated bouts of vomiting are experienced and may be accompanied with loss of appetite, headaches, nausea while not vomiting, and general discomfort. The vomiting does not resolve and antiemetic drugs may not suppress it. Patients can also feel weak or dizzy as a result of the strain associated with vomiting, and may develop complications like sore throats and dental damage.

Pregnancy can sometimes cause intractable vomiting, as can some hormone imbalances. Other causes include certain infections, pyloric obstruction, brain injuries, and drug reactions. When a patient presents with intractable vomiting, a doctor may need to conduct some tests to determine the cause in order to provide the most appropriate treatment. Treatments can include surgery and medications. Because the prolonged intractable vomiting can make the patient weak, there may be increased risks with surgical procedures and the patient needs to be carefully monitored during surgery for signs of complications.

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People who have been vomiting repeatedly over the course of several days are at risk of dehydration due to fluid loss. A doctor may provide intravenous fluids to the patient and can recommend taking in clear bland fluids. Patients will also be checked for other signs of complications, and additional supportive care may be provided to address these issues. Care may be provided in a hospital setting during acute vomiting episodes, with the patient going home once stabilized.

In a condition known as cyclic vomiting syndrome that usually onsets in childhood, patients have periodic episodes of repeated persistent vomiting that may last hours, days, or weeks. Sometimes there is a clear trigger and in other cases there is no known cause. Between episodes, the patient may be quite healthy and active. This condition sometimes resolves as people enter adulthood while in other cases, the cyclic vomiting episodes may continue and can become disabling as the patient may need to miss work and make lifestyle adjustments to manage the vomiting.

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lindajstarke
Post 6

@anon305673: My son had the same symptoms and also had felt that marijuana helped to relieve his episodes. After two years of taking him to over 30 different E.R.'s in three different states, he was finally diagnosed with CVS. His doctor at the clinic he was referred to told him if marijuana helped, he could continue smoking it.

Nine months later, his episodes continued to get worse, and the doctors at the ER he frequented, decided he was no longer welcome there. They felt he was drug seeking, and put him on the do not see list within their hospitals. So, we took him to a state teaching hospital E.R.: UCSD in San Diego. There we were told he had been misdiagnosed by Scripps hospital, and what he really had was called "cannabinoid hyperemesis syndrome". This sounds like what you may have.

KittenHerder
Post 5

@anon322854 - Check out cyclic vomiting syndrome (CVS). You may have this.

anon322854
Post 4

@anon305673 - Sounds like you may suffer from bulimia or anorexia.

anon305673
Post 3

I have been involuntarily puking for about four months now. I always get so hungry to the point I just stay near my toilet and just want to lie down to die.

I'm hoping that if I tell my parents about this they can get me a medical card for medicinal marijuana. Marijuana has helped control my nausea and my asthma.

dfoster85
Post 2

@jennythelib - How awful for your friend! In my family, it was the baby suffering from intractable vomiting.

Now, my baby was a puker, and my husband I kept asking ourselves how we were supposed to know how much spitup was enough to be concerned about. But when my sister's baby had pyloric stenosis, there was no mistaking it! He was throwing up after ever feeding and really getting some distance with it, plus he was just clearly a sick baby (in stark contrast to our "happy spitter").

For that kind of vomiting, the treatment is surgery! It was awfully scary to see a tiny two-month-old baby going in for surgery, but such a relief when he recovered and finally started growing like gangbusters!

jennythelib
Post 1

For pregnant women, intractable vomiting is called hyperemesis gravidarum. A friend of mine had this when she was pregnant with twins. It got so bad that she actually had to be hospitalized. Various things made it better, but nothing made it completely go away. She just threw up time and time again until she finally delivered.

She thinks two kids is probably enough, which is good because she doesn't see how she could go through that again now that she's a mom! Apparently twin moms are often sicker because they have higher HCG levels, so she might do better with a singleton pregnancy--but she says she's not taking any chances!

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