What is Intractable Vomiting?

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.

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.