What should you know about dry vomiting?

Repeated retching may happen with food poisoning, gastroenteritis, migraine, gallstones or pancreatitis. A person may also retch when the stomach is empty, after a strong smell, during intense anxiety, or after coughing. The retching itself can leave the throat and abdominal muscles sore. Dry vomiting is a symptom rather than a diagnosis, so its meaning depends on other features such as abdominal pain, diarrhoea, headache, fever or recent food exposure.

Meningitis is an uncommon but urgent possibility when vomiting occurs with a severe headache, fever, neck stiffness, confusion or marked drowsiness. Rotavirus infection is more relevant in young children and can cause vomiting with diarrhoea and dehydration.

Rest and take small, frequent sips of water or an oral rehydration drink. Large drinks can provoke more retching. Once fluids stay down, try bland foods in small portions and avoid alcohol, greasy meals and strong odours for a while. Keep a note of when the episodes began, possible triggers, urine output and any pain or fever. Do not take someone else’s anti-sickness medicine; a clinician or pharmacist can advise what is suitable.

Seek urgent help for severe or worsening abdominal pain, a swollen abdomen, blood or green material in vomit, fainting, confusion, a severe headache with fever or neck stiffness, or trouble breathing. Arrange medical assessment if retching keeps returning, you cannot keep fluids down, you are passing very little urine, or you have signs of dehydration such as a dry mouth and dizziness. Children, older adults and people who are pregnant or medically vulnerable may need earlier advice.

Ask what may be triggering the retching, whether your symptoms fit food poisoning or another condition, how to replace fluids safely, and which changes should prompt urgent review.