There are a number of reasons why a person might throw up bile, but some of the most common include a lack of anything else to purge after multiple vomiting episodes, intestinal obstructions, and a liver disorder known as bile reflux. In some cases the vomiting may also be a sign of liver damage, usually as a result of excessive drug or alcohol consumption. People who suffer from cyclical vomiting syndrome, a condition that causes sporadic vomiting without warning, may also experience bouts of bile as their stomachs try to compensate for the disruption. Instances of throwing up bile are usually considered serious from a medical perspective, and are almost always signs of a larger problem. Anyone who experiences this problem, particularly if it is recurring, should usually seek the advice of a qualified healthcare provider both to treat the issue in the short term and to prevent further damage into the future.
Bile Basics
Bile is a digestive fluid created in the liver and held in the gallbladder for use in breaking up fat during digestion. It may be yellow or green when expelled, which makes it fairly easy to identify in vomit; it often has the consistency of thick mucus and tends to have a very bitter taste. The main function of bile from a biological standpoint is to neutralize stomach acid and make it easier for the body to digest foods, and it’s usually excreted from the liver into the stomach on a fairly constant basis. In addition to breaking up fats, bile also plays an important role when it comes to flushing bilirubin out of the system, a byproduct of red blood cell breakdown.
Healthy people typically have internal mechanisms that regulate the amount of bile that enters their stomachs, usually in relation to how much food is being consumed or what their specific digestive needs are. When these mechanisms fail, bile can sometimes flow into the stomach in excessive quantities, or can mix with vomit when a person is ill. This is not a normal response to vomiting, and is usually a sign of a larger problem.
Consequence of an Empty Stomach
One exception to the “seriousness” issue may arise in the case of excessive vomiting, usually in response to an intense stomach virus or other temporary irritation. Vomiting bile because the stomach is empty from multiple recent vomiting episodes is often is the body’s defense-mechanism result. That's not to say multiple vomiting episodes should cause no concern, though. A person suffering from nausea and vomiting should be sure to stay well hydrated and may need to consult a doctor if vomiting persists, since prolonged contact with bile can damage the esophagus.
Intestinal Obstructions
When a person has an obstruction in his or her small intestine, this may also cause bile to be expelled. Bile is naturally mixed in with the stomach contents but, once an obstruction is present, the bile can be forced out by vomiting. Some causes of small intestinal obstructions are adhesions, gallstones and inflammatory bowel disease.
Bile Reflux
Bile reflux, a disorder similar to acid reflux, may also be to blame. In this condition, however, the stomach expels bile up the esophagus instead of acid. When there is too much bile in the stomach, the body naturally wants to get rid of it and may respond by vomiting. Bile reflux can be caused by peptic ulcers and gastric surgeries such as gallstone removals. Most stomach surgeries can cause excess bile to build up during the healing phase, but this symptom is often a sign that things aren’t healing quite right.
Drug and Alcohol Use
Drugs and alcohol can also cause this problem. If alcohol is consumed in large quantities and for long periods of time, the stomach lining begins to get irritated, and when this happens the stomach may inadvertently expel bile with vomit. Certain drugs, such as morphine and digitalis, may also cause the brain’s chemoreceptor trigger to fire, which is what causes the urge to vomit. Bile also will often expelled if this happens, particularly if it is already present in large quantities.
Cyclical Vomiting Syndrome
People who suffer from the relatively rare disorder known as cyclic vomiting syndrome (CVS) may also experience bouts of bile in their vomit. This condition is marked by random, often violent vomiting attacks that happen for no apparent reason, which is to say in people who are otherwise healthy. Bouts can last from one to 10 days, and patients will typically see vomiting episodes more than once a month. The constancy and intensity of this condition irritates the stomach, which causes more bile to be produced. The bile is then thrown up so the stomach can rid itself of the excess.
Getting Treatment
It’s usually pretty easy to identify bile in vomit, and anyone who notices this problem consistently — more than once in succession — should usually get a medical check-up to rule out possible serious conditions. Proper liver function and bile production are important parts to overall health. Even short burst of bile vomiting can indicate the presence of a larger problem, and in most cases, the sooner it’s solved, the better the outcome is likely to be.
