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Decoding Vomit Colors : Causes and When to Seek Medical Attention

  1. Introduction

    1. What is Vomiting?

      Vomiting is known as emesis. It is a physiological process in which the contents of the stomach are expelled forcibly through the mouth and sometimes the nose.

      This is a reflex action that is controlled by the vomiting center in the brainstem, which is a protective response to the harmful and irritating substance in the stomach or the upper digestive tract.

      Vomiting is often accompanied by involuntary contractions of the abdominal muscles and preceded by a sensation of nausea or discomfort. It is a common symptom of various medical conditions including infection, gastrointestinal disorders, pregnancy, motion sickness, and side effects of various medications.

    2. Importance of Understanding Vomiting Colors

      Having an understanding of different colors of vomiting is significant for several reasons.

      • Different colors of vomiting are associated with different medical conditions or diets. It can be helpful in understanding the underlying cause.
      • The color may indicate the severity of the condition. For example, red or black vomit may signal bleeding in the gastrointestinal tract, needing immediate medical attention.
      • It can be helpful in tailoring the treatment approach.
      • Some medication supplements and foods alter the color of vomit. Knowing about it can prevent unnecessary worry.
      • Knowing about the color of the vomit, the individual can take proactive steps to prevent it. For example, recognizing the signs of dehydration in vomit color can prompt increased fluid intake.
      • The parents and caregivers can use the knowledge to monitor the health of children or dependents.
      • Understanding the meaning of colors can alleviate unnecessary anxiety and panic.
  2. Different Colors of Vomit and Their Causes

    1. Clear or Watery Vomit

      Clear vomiting usually occurs when a person has thrown up several times and effectively emptied all the stomach food content. It is mostly due to swallowed saliva as there is nothing else in the stomach.

      It may occur due to:(1)

      • Consuming large quantities of water or clear fluids on an empty stomach.
      • Overhydration, which is drinking excessive amounts of water in a short period of time overwhelming the stomach’s capacity.
      • Viral infections affecting the stomach lining, which is often accompanied by diarrhea, vomiting, nausea, and abdominal cramping.
      • Food poisoning, which occurs due to ingesting contaminated food or water. The body expels the irritant through vomiting.
      • Morning sickness during pregnancy. The females during this time experience clear and watery vomit due to hormonal changes and increased sensitivity to certain smells and tastes.
      • Excessive alcohol consumption irritates the stomach lining leading to watery vomit.
      • Motion sickness also causes watery vomit. In it the inner ear senses motion but the eyes do not.
      • Some medications may irritate the stomach lining and lead to clear and watery vomit.
      • Anxiety and high-stress situations can lead to psychogenic vomiting resulting in clear and watery vomit.
      • In appendicitis, the first vomit may be clear followed by a more typical appearance.
    2. White Vomit

      White color vomit occurs when a person has eaten white foods such as milk, yogurt, ice cream, double cream, or whipped cream. Some of the conditions causing white vomiting include:(2)

      • Gastric outlet obstruction, in which there is a blockage that prevents food and stomach content from passing into the intestine. This leads to regurgitation of gastric secretions, which may appear white.
      • Blockage of the bile duct can also result in pale or white-colored vomit.
      • Hepatitis or cirrhosis can disrupt the bile production and flow. This may make vomiting appear lighter.
      • Celiac disease or pancreatic insufficiency may lead to impaired nutrient absorption, resulting in pale or white vomiting.
      • A congenital condition in which the bile ducts are absent or blocked may lead to a build-up of bile in the liver. This may result in white color vomiting.
      • Excessive alcohol consumption can irritate the stomach lining leading to the expulsion of gastric juices, that may appear white.(3)
    3. Green Vomit

      Green vomiting may suggest that a person is vomiting bile.(4)

      Bile is a substance produced by the liver to break down fat during digestion. The green color means the bile has yet not been digested by the stomach.

      The green bile comes from the upper duodenum. The green vomit may mean that there is an obstruction or any other potential issue.

      The various conditions in which green vomit may occur include:

      • Bile reflux, in which the bile flows backward into the stomach.
      • Gastric outlet obstruction is blockage at a point where the stomach empties into the small intestine. It leads to regurgitation of stomach contents.
      • Gastric ulcers in the stomach and duodenum lead to irritation and inflammation of the stomach lining. This may cause vomiting of bile.
      • Intestinal obstruction may lead to a backup of content, including bile that may be vomited up.
      • Viral and bacterial gastroenteritis leads to inflammation of the stomach and intestine causing vomiting. There may be a presence of partially digested food and bile in the vomit.
      • Food poisoning leads to severe vomiting. The presence of bile and other digestive fluids may contribute to green-colored vomit.
    4. Yellow Vomit

      Yellow vomiting is an indication that the bile already digested in the stomach is vomited.(4)

      This is not of much concern and may suggest that the stomach is empty.

    5. Orange Vomit

      The orange color of the vomiting is due to partially digested foods. A person may experience orange vomit for several hours till the stomach fully empties.

      Orange vomiting may occur due to the following illnesses:(5,6)

      • Certain foods and beverages with strong orange color can cause orange-colored vomit.
      • In gastroesophageal reflux disease, the partially digested food flows back into the esophagus leading to orange-colored vomiting.
      • Blockage at a point where the stomach empties into the intestine can cause regurgitation of the stomach content which may include bile and partially digested food.
      • Consuming substances such as medications and herbal supplements with orange pigment can lead to orange-colored vomiting.
      • Inflammation of the pancreas interferes with the production and release of digestive enzymes. This can potentially change the color and consistency of the vomit.
      • Biliary atresia can also cause orange-colored vomiting.
    6. Pink or Red Vomit

      Pink or red vomit may be due to the presence of blood. Throwing up of blood may indicate bleeding from the gastrointestinal tract, which may be due to the following conditions:(7)

      • Gastrointestinal bleeding, in which depending on the location and severity of bleeding, the vomiting may be pink, red, or may even resemble coffee grounds.
      • Ulcers in the stomach and duodenum
      • Esophageal varices, which are the enlarged veins in the esophagus that may get ruptured and cause bleeding.
      • Mallor-Weiss tear, which occurs in the lower part of the esophagus or upper part of the stomach mostly due to severe vomiting.
      • Esophagitis or the inflammation of the esophagus can cause irritation and severe bleeding resulting in pink or red vomit.
      • Nasal bleeding or epistaxis can lead to blood being swallowed and subsequently vomited.
      • Stomach cancer can cause bleeding within the stomach leading to red or dark-colored vomit.
    7. Brown Vomit

      Brown vomit may also suggest the presence of blood in vomit. It may be due to the following conditions.(8)

      • Gastric bleeding may be brown-colored bleeding due to the presence of partially digested blood.
      • In bile reflux when the bile flows back into the stomach and mixes with stomach contents it may lead to brown-colored vomit.
      • Intestinal obstruction, which is the blockage of the small intestine leads to the back-up of the stomach contents including bile and partially digested foods resulting in brown vomit.
      • In some cases, lower intestinal bleeding can lead to blood in the vomit giving it a brown color.
      • Pancreatitis is the inflammation of the pancreas. It can interfere with the release of digestive enzymes leading to changes in the color and consistency of vomit including brownish hue.
    8. Black Vomit

      Black vomit may signify that it contains blood. It may partially be due to digestion and oxidation of the blood that may have sustained in the stomach.(8)

      It has similar causes to brown vomit.

  3. When to Consult a Doctor?

    Reaching out for a doctor’s help is important if the symptoms of vomiting do not ease in 1-2 days. The doctor can address the cause and symptom and recommend the most appropriate option doctor should be consulted in any of the following conditions:

    • If there is an inability to keep down fluids
    • Signs of severe dehydration
    • Dizziness
    • Headache
    • Weight loss since the illness
    • If the vomiting lasted more than 48 hours

    Immediate medical attention should be looked for in the below-mentioned cases:

    Someone should immediately contact emergency medical services if they think they may have ingested something poisonous.

  4. Conclusion

    Vomiting is linked with several health concerns, some of which are really concerning while others are short-lived.

    The color and texture of vomiting may indicate an underlying health condition. Black, red, and brown vomiting may indicate a serious health concern and it would be important to seek medical attention. Also, if the vomiting lasts for more than 48 hours a doctor should be consulted irrespective of the color or texture of the vomit.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 3, 2023

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