Late at night, you're suddenly jolted awake with a queasy feeling. Expecting the usual signs of a stomach bug, you're taken aback when things look different this time. Instead of the typical upset, there's something unusual that catches your eye. Concerned, you realize this isn't just another night of feeling sick—it might be something your body is urgently trying to communicate. Maybe it's time to dig deeper and find out what's really going on.
Throwing up is almost always disturbing, but it is especially so if a person is vomiting a thick, yellow fluid instead of the usual stomach contents. This liquid, called bile, is usually yellow, though it can have some green coloration. Vomiting bile can be a sign of a serious medical problem, but it more typically happens due to pregnancy, the stomach flu, food poisoning, or when vomiting while the stomach is already empty. Medical experts may use the term "bilious vomit" to refer to throwing up bile. Understanding what might be causing someone to throw up bile allows them to seek medical attention when necessary.
Bile is a yellow or greenish-yellow fluid that the liver produces and the body stores in the gallbladder. The liquid may consist of a mixture of cholesterol, bile salts, bile acids, water, bilirubin, and some metals. The color comes from bilirubin, which is normally yellow but turns green after exposure to air.
Bile enters the small intestine during digestion to help break down fats, allowing the body to better absorb them. It sometimes appears in vomit after something causes the bile to travel from the small intestine into the stomach.
A person may throw up bile for a variety of reasons. The most common causes of vomiting yellow bile are events that already involve vomiting, such as food poisoning or drinking too much. However, these reasons don't explain why the bile was in the stomach in the first place. Usually, this is due to bile reflux, which essentially describes a malfunction of the muscular passage between the stomach and lower intestine that allows the bile to enter the stomach. However, it can also occur due to a hiatal hernia or an intestinal blockage.
Bile reflux and acid reflux are extremely similar. In fact, the two often occur together. The difference lies in the location where the reflux occurs. Acid reflux describes the stomach contents entering the esophagus, while bile reflux refers to bile entering the stomach from the small intestine. Medications and lifestyle adjustments like weight loss are effective treatments for acid reflux, but bile reflux may take more dramatic treatments, including more powerful medications that coat the stomach and lessen the severity of bile reflux symptoms, or it may include surgical interventions
A variety of more serious digestive health conditions have links to vomiting yellow bile and bile reflux. For example, should bile reflux occur due to an intestinal blockage, that blockage may have formed because of colorectal cancer or other cancerous tumors.
Inflammatory bowel disease, including conditions like Crohn's or ulcerative colitis, causes inflammation and blockages in the small intestine. Even something such as volvulus—twisting of the intestine—may be responsible.
Recognizing the symptoms that may occur alongside vomiting yellow bile allows a non-professional to know if they could have a serious underlying condition. Keep an eye out for symptoms that point to an intestinal blockage, such as bloating, frequent vomiting, abdominal pain, or swelling of the abdomen.
Some blockages form after surgery for other problems. If a hernia is responsible, an individual will likely also have throat irritation, belching, heartburn, and acid reflux.
Figuring out why a person is vomiting bile can be a difficult process. Depending on the initial findings, healthcare providers will run several tests to investigate the usual causes. Blood tests are extremely common, as are imaging tests like CT or MRI scans. Sometimes, a doctor may need to use an endoscope camera to view the esophagus and stomach.
HIDA scans are also useful, as they allow professionals to track the flow of bile from the liver to the small intestine and see if there are any issues along the way.
Treatments for vomiting yellow bile are as varied as the causes. Simple, supportive care like fluids and anti-nausea drugs can help with stomach flu, but major problems like hiatal hernia may require surgery. Should someone have chronic episodes of bile reflux, doctors may use medications like sequestrants to limit the flow of bile—though these are not particularly effective. Muscle relaxants and antacids can provide some relief from the symptoms, while options like ursodeoxycholic acid help break the bile down.
While most causes of yellow bile are manageable problems like food poisoning, the risk of a serious disorder is still present. A person who vomits yellow bile should immediately seek medical attention if they are also experiencing several other specific symptoms. A high fever is one of the most important signs that the body is experiencing major distress. Immediate medical attention is also necessary if vomiting persists for 24 hours, nausea persists for several days, or if it is impossible to keep food or water down while vomiting occurs three or more times in a day.
Though issues with bile reflux and vomiting yellow bile aren't as simple to address as something like acid reflux, it is still possible to take preventative measures. Smoking and stress have links to a range of gastric health problems, including bile and acid reflux. The same is true for being overweight. Some people find that lying down or reclining after or during meals causes their symptoms to worsen. For this and other concerns—such as poor sleep quality—avoid eating right before sleep. Cut out binge drinking and try to avoid circumstances that could lead to food poisoning, as well.
Chronic problems with bile vomiting can be extremely distressing. Some long-term options that could help with symptom severity include eating smaller meals several times a day to prevent the stomach from ever feeling too full. When lying down, place several pillows under the back and head to avoid acid and bile reflux. Stay hydrated and drink plenty of water. Should these techniques not work, it may be necessary to try stress-relieving activities like yoga, meditation, or counseling.
Vomiting yellow bile, while potentially disturbing, is not usually a sign of a major medical problem. Simple triggers like drinking too much or even just being pregnant can be enough to make someone throw up bile. However, should the vomiting occur alongside symptoms like fever, persistent vomiting, or abdominal pain, there could be a serious underlying illness. Staying aware of these symptoms and practicing an active lifestyle with a healthy diet is the best way to avoid problems—and identify them quickly should they occur.
This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.