Vomiting Bile: Understanding the Causes and Treatments

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Vomiting BileI remember in college that, after several nights of excessive and admittedly impressive partying, my friends found themselves vomiting bile after drinking alcohol.

In fact, that level of drinking had become standard after a while, to the point where my friends thought that vomiting bile in the morning after a binge was just… normal. I’m happy to say that these days, they’ve gotten a lot better at handling their alcohol.

Bile, sometimes called bile juice, is a digestive fluid made by the liver and stored in the gallbladder. It contains bile acid, which promotes fat absorption.

A person vomits bile as a result of a malfunctioning pyloric valve, a ring-shaped sphincter muscle in the stomach. Normally, the pyloric valve closes after food enters the small intestine, so that stomach contents do not flow backward, but if the pyloric valve doesn’t close properly, there is a backflow of bile to the stomach, which can lead to bile reflux.

What Does it Mean When You Throw Up Yellow or Green Bile?

Vomiting is a normal way in which the body expels toxins, though vomiting bile is by no means a pleasant experience. If it occurs, it usually happens in the morning.

The color of the vomit may be surprising for some people; it may be an indication that toxins haven’t fully been removed from the body. Sometimes the color of the vomit may be related to the breakdown of food. For example, vomit may be green or yellow in color after eating yellow or green foods; the color may even be enhanced so it appears as though the person is throwing up lime green. Foods that can produce yellow or bright green vomit in adults include corn, carrots, asparagus, or spinach.

Other times the vomit color is a sign of something more serious. When a person normally vomits, the color is orange or brown, or a mix of both. That said, brown vomit that smells similar to fecal matter is an indication of the bowels being backed up, which can make digestion problematic or almost impossible, and will require immediate medical attention.

Bile, however, is greenish-yellow in color. Vomiting green bile or yellow bile is common when on an empty stomach because the body has nothing to expel aside from digestive juices.

Causes of Vomiting Bile

Vomiting bile is also a sign that a person is suffering from a particular condition, such as bile reflux. Since bile is made in the liver and stored in the gallbladder, gallbladder removal surgery or a liver infection can lead to vomiting. There are also various other causes of vomiting bile in adults, such as:

  • Gastroenteritis: Gastroenteritis is commonly known as the stomach flu. It’s similar to food poisoning, and is caused by contaminated food or water. Gastroenteritis makes it difficult for a person to digest food, and as a result, they may vomit bile after meals, and experience diarrhea, abdominal cramps, and dehydration.
  • Cyclical vomiting syndrome: Cyclical vomiting syndrome is a mysterious condition where vomiting occurs episodically and seemingly for no reason at all. Strangely, episodes of vomiting tend to happen at the same time every day, exhibit the same intensity, and last for the same amount of time. Potential triggers of cyclic vomiting syndrome include extreme excitement, infections, emotional stress, and menstruation.
  • Food poisoning: What causes vomiting bile and diarrhea? Food poisoning is another potential cause, and it occurs when food is contaminated with bacteria and viruses. Other symptoms include abdominal pains and a fever.
  • Food allergies: Certain foods can trigger allergic reactions, which could induce vomiting. Other symptoms include skin rashes, stomach cramps, breathing issues, and a runny nose.
  • Extreme dehydration: When the body is lacks water and nutrients, dehydration may occur. Symptoms include vomiting, dizziness, lightheadedness, and low blood pressure.
  • Intestinal blockage: An intestinal blockage or twisted intestine prevents food from passing through the intestines, which can result in vomiting yellow bile.
  • Respiratory inflammation: Vomiting yellow bile can as result from a respiratory tract inflammation or infection such as the common cold or pneumonia. This occurs due to the large amount of mucus that forms during respiratory infections, which can gradually build up and lead to vomiting.
  • Pyloric valve malfunction: Pyloric valve malfunction is common in the elderly. Since the pyloric valve regulates the release of bile, a malfunction in this sphincter muscle can lead to vomiting bile. The combination of stomach acid and bile can also lead to heartburn.

Is Alcohol the Culprit Behind Vomiting Bile?

As my college friends understood back then, vomiting yellow bile after drinking is (or rather, was) common. The body wants to remove the alcohol, but the alcohol remains in your system and irritates the stomach lining, so you vomit up bile instead. Vomiting bile after drinking alcohol may also be a sign that the body simply has a low tolerance toward alcohol.

As a result of this alcohol intolerance, the body attempts to remove the toxic substances and bile from the body. Also, vomiting bile in the morning is considered to be much worse than vomiting at night; this can result in a vomiting bile hangover. You should then try to drink water after vomiting bile to avoid dehydration.

However, if the vomiting is accompanied by other symptoms such as seizures, slow or irregular breathing, blue or pale skin, low body temperature, or an inability to wake up after passing out, then the person may be suffering from alcohol poisoning and will need immediate medical help.

Symptoms of Vomiting Bile

Besides the vomiting, there are other symptoms and signs associated with bile reflux, and these symptoms are similar to acid reflux, and they include:

  • Unintentional weight loss;
  • Nausea;
  • Upper abdominal pain, sometimes severe;
  • Frequent heartburn which may spread to the throat and produce a sour taste in the mouth; and
  • Occasional coughing or hoarseness in the throat.

Is Vomiting Bile a Sign of a Serious Health Condition?

Vomiting bile, or vomiting in general, may also be a sign of a serious health condition, such as appendicitis. If you experience pain that suddenly worsens and spreads across the abdomen, this is a sign that your appendix may have burst, and you should seek medical attention immediately.

Frequent vomiting can also be an early sign of a severe brain injury, and shouldn’t be disregarded, as ignoring this sign could lead to serious brain damage. For example, after a concussion, you may increase the likelihood of developing epilepsy. Intense migraine headaches can also occur as a result from a brain injury, and a doctor should be contacted right away if severe vomiting is also noticed. And sometimes, brain damage can be fatal.

Vomiting bile and motion sickness are linked with pregnancy. Severe vomiting can lead to dehydration, which can be dangerous for both the mother and baby. Other causes of vomiting bile in adults include inflammation of the gallbladder, kidney stones, kidney infections, radiotherapy, chemotherapy, and taking medications such as opioid painkillers and antibiotics.

Home Treatments for Vomiting Bile

In many cases, the best treatment for throwing up bile depends on the cause of the vomiting. Your doctor may recommend a variety of medications, such as bile acid sequestrants that will interfere with bile circulation and limit vomiting and other digestive symptoms. Other drugs used for digestive disorders and to limit bile production include pro-kinetic agents, ursodeoxycholic acid, and proton pump inhibitors. However, there are also a number of natural remedies for vomiting as well, such as:

  • Bile salts: People who have had their gallbladder removed will have trouble concentrating bile acids, so bile salts can help. The typical dosage is 200 to 1,000 milligrams, taken with food, particularly a fatty meal. Supplementing with taurine (an amino acid) can also enhance the body’s ability to produce bile salts. Bile salts can also help those who suffer from liver issues or experience problems absorbing fats.
  • Keep hydrated: Severe vomiting can lead to dehydration and bile loss, so it’s important to drink eight to 10 glasses of water (eight ounces each) per day to stay hydrated. Adding an electrolyte solution or foods such as lemon or lime juice can also help maintain electrolyte balance, which can help alleviate vomiting and other symptoms.
  • Detect food allergies or sensitivities: Food allergies or sensitivities may trigger an allergic reaction which may lead you to vomit bile and ingested food, so detecting potential food triggers can help. The most common food sensitivities and allergies include wheat, gluten, and dairy products. An enzyme-linked immunosorbent assay (ELISA) and food elimination diet can help detect food allergies, while sensitivities can be detected with tests such as a meridian stress assessment test, bio-analysis with bio-energetic testing, and a bio-meridian test.
  • Dietary restrictions: Besides eliminating food allergies, it’s a good idea to replenish the electrolytes lost from food poisoning, including sodium, potassium, and calcium. Avoiding foods that increase acid production such as carbonated drinks, spicy foods, tomato-based foods, chocolate, citrus foods, and caffeinated foods and drinks can also help.
  • Anti-vomiting herbs and foods: Ginger in particular is considered a very effective method to help reduce vomiting when consumed as a tea or just eaten raw. Foods and herbs that stimulate bile are known as cholagogues, and these include dandelion, mustard greens, turnip greens, artichokes, chicory, and radishes. Cholagogic herbal supplements often contain dandelion in combination with greater celandine, fringe tree, blue flag, boldo, and wormwood. Other herbs that help reduce vomiting include cinnamon, yellow dock, peppermint, meadowsweet, cloves, black horehound, comfrey, rosemary, Iceland moss, and false unicorn root. Onions and apple cider vinegar can also stop vomiting.
  • Essential oils: Aromatherapy can help treat bile reflux and vomiting. Some effective essential oils for this include lavender, mint, black pepper, nutmeg, rosewood, rose, sandalwood, sweet fennel, coriander, close bud, chamomile, cascarilla bark, French basil, lemon balm, allspice, and cardamom.

How to Prevent Vomiting Bile

There are also certain measures that can help prevent vomiting bile, or vomiting in general, including:

  • Stress reduction: Severe and frequent vomiting can understandably cause stress. Ways to reduce stress include meditation, or light exercise such as restorative yoga, tai chi, or qigong.
  • Limiting food intake: Eating smaller meals can help prevent vomiting. Try consuming bone broths, which can help improve digestion and reduce nausea and vomiting.
  • Avoid sleeping after eating: Immediately sleeping after dinner is a bad idea. Stay upright for a minimum of two or three hours after eating a meal, as this allows for most of your food to digest.
  • Avoid alcohol and certain drugs: Drinking alcohol relaxes the esophageal sphincter and can lead to irritation. It’s also a good idea to avoid antibiotics and opioid painkillers.

When to See the Doctor

If you are vomiting bile frequently (i.e., more than once during the day or the week), you need to immediately contact your doctor. Although you likely won’t need to enter the emergency room, it’s important to rule out any underlying serious conditions. It’s also a good idea to talk to your doctor if you’ve been unintentionally losing weight, or you’re experiencing bile reflux, or have also been diagnosed with gastroesophageal reflux disease. Other signs that will warrant a trip to the doctor’s office include:

  • Abdominal pain or chest pain;
  • Lightheadedness;
  • Shortness of breath; and
  • Recurrent flu symptoms that are worse before vomiting, such as coughing, fatigue, sneezing, or a runny nose.

Other Tips for Treating Vomiting Bile

Don’t resist the urge to vomit—after all, vomiting is the body’s way of getting rid of something it thinks is harmful. Also, get a good night’s sleep; getting at least seven hours of sleep each night will reduce stress, and can help prevent you from vomiting bile.

Sources for Today’s Article:
Hoffmann, D., Holistic Herbal: A Safe and Practical Guide to Making and Using Herbal Remedies (Hammersmith: Harper Collins Publishers, 1990), 255.
Lawless, J., The Encyclopedia of Essential Oils: The Complete Guide to the Use of Aromatic Oils in Aromatherapy (San Francisco: Harper Collins Publishers, 2013), 203.
Lipski, E., Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion (New York: McGraw-Hill, 2012), 35–36, 264.
“Bile Reflux: Symptoms,” Mayo Clinic web site; http://www.mayoclinic.org/diseases-conditions/bile-reflux/basics/symptoms/con-20025548, last accessed April 11, 2016.

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Jon Yaneff, CNP

About the Author, Browse Jon's Articles

Jon Yaneff is a holistic nutritionist and health researcher with a background in journalism. After years of a hectic on-the-go, fast food-oriented lifestyle as a sports reporter, Jon knew his life needed a change. He began interviewing influential people in the health and wellness industry and incorporating beneficial health and wellness information into his own life. Jon’s passion for his health led him to the certified nutritional practitioner (CNP) program at the Institute of Holistic Nutrition. He graduated with first... Read Full Bio »