Green or yellow vomit can be impressive. Their taste is often very bitter. This color comes from bile, a digestive fluid produced by the liver and stored in the gallbladder. When it goes up to the stomach and then to the mouth, we speak of bilious vomiting. They can appear after gastroenteritis. But they can also reveal a medical emergency, such as an intestinal obstruction.
Vomiting bile in adults: when should you consult?
Bile is naturally yellow. But when it is vomited, it may appear dark green. According to the Cleveland Clinic, this color reflects a reflux of bile when the stomach is empty or when an obstacle blocks the digestive tract lower down.
To know whether to worry, two elements are important: age and context. In adults, vomiting bile after gastroenteritis, on an empty stomach or during hyperemesis gravidarum is often temporary.
Moreover, yellow vomit often appears after several episodes of vomiting. This is a common case at the end of gastroenteritis or after significant alcohol consumption.
However, green vomit should prompt consultation if it is accompanied by severe stomach pain, fever, blood in the vomit or an inability to drink.
Vomiting that lasts more than two days should also be a warning. In France, Ameli reminds that in case of distress or doubt about a vital emergency, you must call 15 or 112.
Baby vomiting bile: a medical emergency
In newborns and infants, bilious vomiting is always taken very seriously. According to Presse Santé, they can reveal an intestinal obstruction, such as duodenal atresia or another malformation. The American learned societies of radiology point out that
“Bilious vomiting during the first two days of life may be caused by a blockage in the intestine.”
Some causes, such as malrotation or volvulus, are life-threatening emergencies. In these situations, the intestine can twist and completely block the passage.
When it comes to tests, an x-ray is usually taken first. If necessary, an examination with contrast product can then locate the blockage.
Pediatricians consider that a baby who vomits bile, especially during the first two days of life or if the vomiting is repeated, should be taken to the emergency room without delay. Repeated vomiting, even without fever, therefore requires rapid medical advice.
What does the doctor do in case of bilious vomiting?
In adults, the doctor begins by looking for the cause. He is interested in symptoms, possible gastroenteritis, alcohol consumption, pregnancy or current treatments. He then examines the abdomen and may order tests or imaging.
The goal is to look for intestinal obstruction, a stone in the common bile duct, bile reflux, or liver disease. According to Presse Santé, treatment may include medication for nausea, an infusion to correct dehydration or surgery if an obstruction is confirmed.
In infants, a suspicion of obstruction requires hospitalization. The child is fasted and receives an infusion while waiting for the exams. An operation may be necessary if the diagnosis is confirmed.
When bilious vomiting is linked to gastroenteritis or hyperemesis gravidarum, treatment is mainly aimed at relieving nausea and preventing dehydration. A healthcare professional will then be able to determine if additional examinations are necessary.