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Vomiting of bile: when is it serious?

Bilious vomiting means that a person’s vomit is greenish-yellow, which is the color of bile. The liver produces bile, a digestive fluid. Bilious vomiting can mean that a person has a blockage somewhere in the gastrointestinal tract. They can also occur when a person vomits on an empty stomach. Also, they often occur in babies born with intestinal obstruction. Parents and caregivers who notice bile-colored vomiting in an infant, especially during the first two days of life, should seek urgent medical attention. Read on to learn more about bilious vomiting, its causes, risk factors, and more.

What is ?

Bilious vomiting means that a person’s vomit is the color of bile. This is usually green, yellow, or a mixture of both. It usually has a very bitter taste. In general, bilious vomiting is benign, that is, harmless. They often occur when a person vomits on an empty stomach. However, in babies they can be a cause for concern. Bilious vomiting in infants can be a sign of a malformed gastrointestinal tract.

Causes of bilious vomiting

Bilious vomiting usually occurs when something prevents bile from passing through the digestive tract normally. This usually indicates some type of obstruction. One of the most common causes in newborns and young children is duodenal atresia, a condition in which the small intestine does not develop properly. Babies are born with this condition.

It causes vomiting, often bilious, during the first or second day of life. This usually happens after the first feeding.

Other factors can cause bilious vomiting in children and adults. These include the following factors:

– vomiting on an empty stomach
– a gallstone in the common bile duct
– other congenital obstructions, such as a duodenal diaphragm
– intestinal obstruction
– Hirschsprung’s disease, a congenital intestinal disorder that affects the large intestine’s ability to move stool
– pregnancy, in particular hyperemesis gravidarum, which can cause severe vomiting that can endanger the pregnancy and the pregnant person.

Risk factor’s

Anyone can vomit bile. Circumstances that increase the risk are:

– the pregnancy
– be a newborn or a baby
– recent illness causing severe vomiting
– liver or gallbladder disease
– Presence of other congenital anomalies of reliable origin, such as Down syndrome.

Bilious and non-bilious vomiting

Vomiting is relatively common and most people experience it at one time or another. Most vomiting is nonbilious, meaning the vomit is not the color of bile.

The causes of non-bilious vomiting are:

– the pregnancy
– infections, such as food poisoning
– appendicitis
– exposure to drugs or toxins

Nonbilious vomit is usually neither green nor yellow. However, nonbilious vomiting may appear to be bilious vomiting. A person’s vomit can be different colors depending on the foods he eats, how often he vomits, how much water he drinks, and other factors.


In an infant or newborn, doctors often assume that bilious vomiting is due to a blockage somewhere in the intestinal tract. For this reason, bilious vomiting is likely to be treated as an emergency. They will order imaging tests that may include an X-ray or contrast imaging, which involves injecting a dye into the body and then doing a CT scan.

In adults, doctors will assess the general context in which bilious vomiting occurs. Can :

– ask about a recent illness or ask for a pregnancy test
– ask if the person vomited on an empty stomach
– perform an exam to check for other symptoms, such as tenderness in the upper abdomen
– Order tests to look for gallstones or a blockage.


Treatment depends on the likely cause of a person’s vomiting. When there is no obvious cause, the doctor may recommend waiting to see if the person’s condition improves. However, in infants, the condition will be treated urgently. If doctors determine a blockage, such as duodenal atresia, is the cause, surgery can treat the condition. Without surgery, the baby may not be able to absorb nutrients, so the doctor may recommend surgery right away.

Here are other possible treatments:

– anti-nausea medications to stop vomiting
– treatment of an underlying infection
– surgery to remove a blockage
– removal of the gallbladder if a person has gallstones
– administration of intravenous (IV) fluids to prevent dehydration.


The prognosis depends on the cause of the bilious vomiting. In most cases, the prognosis is good with proper treatment. Many people may not need any treatment. For example, a person may vomit bile if they are pregnant and have morning sickness on an empty stomach or if they vomit on an empty stomach during a stomach virus.

However, there is a risk of dehydration in case of severe vomiting. A condition called hyperemesis gravidarum, which is a severe type of morning sickness, can cause this. In this case, the person may need anti-nausea medication or IV fluids.


Biliary vomiting can be concerning, especially if the person does not know the reason for the vomiting. However, they can be treated and, in adults, may go away on their own. Parents and caregivers should treat bilious vomiting in newborns and very young infants as a medical emergency that requires immediate attention, especially if the vomiting occurs after the baby’s first feeding. A doctor can determine the cause of the vomiting and treat it accordingly.

* Presse Santé strives to transmit health knowledge in a language accessible to all. In NO CASE, the information provided can not replace the advice of a health professional.

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