Where There Is No Doctor 2011 161
VOMITING
Many people, especially children, have an occasional ‘stomach upset’ with
vomiting. Often no cause can be found. There may be mild stomach or gut ache or
fever. This kind of simple vomiting usually is not serious and clears up by itself.
Vomiting is one of the signs of many different
problems, some minor and some quite serious, so it is
important to examine the person carefully. Vomiting often
comes from a problem in the stomach or guts, such
as: an infection (see diarrhea, p. 153), poisoning from
spoiled food (p. 135), or ‘acute abdomen’ (for example,
appendicitis or something blocking the gut, p. 94). Also,
almost any sickness with high fever or severe pain may
cause vomiting, especially malaria (p. 186), hepatitis
(p. 172), tonsillitis (p. 309), earache (p. 309), meningitis
(p. 185), urinary infection (p. 234), gallbladder pain
(p. 329) or migraine headache (p. 162).
Danger signs with vomiting—seek medical help quickly!
• dehydration that increases and that you cannot control (p. 152)
• severe vomiting that lasts more than 24 hours
• violent vomiting, especially if vomit is dark green, brown, or smells like shit
(signs of obstruction, p. 94)
• constant pain in the gut, especially if the person cannot defecate (shit)
or if you cannot hear gurgles when you put your ear to the belly (see acute
abdomen: obstruction, appendicitis, p. 94)
• vomiting of blood (ulcer, p. 128; cirrhosis, p. 328)
To help control simple vomiting:
♦ Eat nothing while vomiting is severe,
♦ Sip a cola drink or ginger ale. Some herbal teas, like camomile,
may also help.
♦ For dehydration give small frequent sips of cola, tea, or
Rehydration Drink (p. 152).
♦ If vomiting does not stop soon, use a vomit control medicine like
promethazine (p. 385) or diphenhydramine (p. 386). But do not
give these medicines to children under 2 years old.
Most of these come in pills, syrups, injections, and suppositories (soft pills you
push up the anus). Tablets or syrup can also be put up the anus. Grind up the tablet
in a little water. Put it in with an enema set or syringe without a needle.
When taken by mouth, the medicine should be swallowed with very little water
and nothing else should be swallowed for 5 minutes. Never give more than the
recommended dose. Do not give a second dose until dehydration has been
corrected and the person has begun to urinate. If severe vomiting and diarrhea make
medication by mouth or anus impossible, give an injection of one of the vomit‑control
medicines. Promethazine may work best. Take care not to give too much.