Projectile vomiting and norovirus

Norovirus is a contagious stomach infection that may begin abruptly with vomiting, watery diarrhoea, stomach cramps and nausea. Vomiting can look projectile when the stomach empties forcefully, but that description alone cannot identify the cause. Food poisoning, gastroenteritis and rotavirus infection can produce similar symptoms. Migraine, gallstones or pancreatitis may cause vomiting with other characteristic symptoms. Meningitis is an uncommon but serious possibility when vomiting occurs with a severe headache, stiff neck, confusion or marked light sensitivity.

Take frequent small sips of water or an oral rehydration drink rather than a large glass at once. Pause briefly after vomiting, then restart with small amounts. When fluids stay down, try plain foods and avoid alcohol, rich meals and foods that worsen nausea. Wash hands thoroughly with soap and water, clean contaminated surfaces and avoid preparing food for others while unwell. Do not give anti-vomiting medicine to a child unless a clinician recommends it. Rest and monitor urine output, alertness and ability to drink.

Seek urgent help for blood or green vomit, severe or worsening abdominal pain, a swollen abdomen, fainting, confusion, a stiff neck, breathing difficulty or a severe headache. Contact a clinician promptly if vomiting keeps returning, fluids will not stay down, urine becomes very limited, the mouth is dry or the person is unusually sleepy. Babies, older adults and people with significant medical conditions can become dehydrated more quickly and should be assessed early. Use the Vomiting page for related warning signs.

Tell the clinician when vomiting began, how often it occurs, whether diarrhoea or pain is present, what fluids have stayed down and when urine was last passed. Ask whether testing, rehydration treatment or isolation advice is needed.