Excessive Vomiting: Dehydration, Electrolyte Imbalance & When to Seek Emergency Care

Frequent vomiting depletes fluids and electrolytes (sodium, potassium, chloride), causing dehydration, metabolic alkalosis, and potentially life-threatening complications.

Risks

• Muscle cramps, weakness, arrhythmias, seizures, renal failure.
• Esophageal tears (Mallory-Weiss) or rupture (Boerhaave) → bleeding, mediastinitis.

Red Flags for Immediate Care

• Inability to keep fluids down >24 hours.
• Signs of dehydration: dry mouth, oliguria, dizziness, confusion.
• Blood in vomit (hematemesis) or coffee-ground material.
• Severe abdominal pain.

Treatment

IV fluids, electrolyte repletion, antiemetics (ondansetron, metoclopramide), and addressing underlying cause (gastroenteritis, obstruction, pregnancy, toxins).