Why am I vomiting green or yellow bile

Bile is made of the following:

What to Know About Yellow Bile

Bile is a greenish-yellow liquid made and released by the liver and stored in the gallbladder. It aids in the digestion of food and fluids by breaking down fats into fatty acids. Your body then takes up these acids into the digestive tract. Bile also aids the body in breaking down:

• Cholesterol
• Salts
• Bile acids
• Bilirubin (a breakdown agent of red blood cells)
• Water
• Certain minerals

What Is Yellow Bile Reflux

Bile reflux is a disabling condition that affects the function of the stomach. The condition presents itself as abdominal pain, bilious vomiting, and weight loss. It happens because of the free movement of duodenum contents into the stomach and other proximal small bowel constituents. In other words, bile flows back into the stomach instead of moving through the small intestines. The condition is also known as gastroesophageal reflux.‌

Large amounts of bile are secreted into the intestines every day. Your body loses only relatively smaller amounts. This is because a large proportion of the acids are absorbed back into the blood within the ileum.‌

Sometimes when you vomit, you may notice a greenish-yellow material, which could be bile. If you vomit bile more than once, you could be having a medical condition responsible for the problem. Yellow bile is usually a result of changes in the body due to the underlying condition. In most cases, it’s no cause for concern, especially if you vomit while your stomach is empty.

Symptoms of Bile Reflux

You may have a variety of symptoms when you have bile reflux. Here are a few of them.

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Diarrhea: This is the main symptom of bile reflux. When the bile acids are not properly re-absorbed from the ileum, they pass into the large intestine (colon). This irritates the lining of the colon and stimulates salt and water secretion.‌

Stomach problems. These include bloating, cramping, abdominal pain, and excessive wind.‌

Heartburn. When you feel a burning sensation that radiates towards the throat or mouth, it could be because of bile reflux. It occurs after meals, in the supine position, and after bending over or heavy lifting. Consuming hot, spicy, or acidic foods and drinks often provokes heartburn, too.‌

Regurgitation. This is the effortless return of gastric content into the esophagus and frequently in the mouth. It can happen during the day or at night. Regurgitated foods or fluids can be acidic or bitter.

‌Chest pain. Chest pain is a lesser common symptom of bile reflux. But it could be an alarming symptom of mechanical obstruction that can cause vomiting of yellow bile.

Causes of Yellow Bile in Vomit

There are several reasons why you may find yellow bile in your vomit. Here are a few:

• You may have a hiatal hernia, where the upper part of your stomach pushes upwards into the chest through an opening in your diaphragm.
• You might be experiencing increased pressure on the abdomen from being overweight or obese.
• It may be caused by certain medications you’re taking, such as certain asthma medicines, antihistamines, pain relievers, sedatives, and antidepressants.
• You’re a smoker or are exposed to second-hand smoke often.
• You have certain neurological conditions such as cerebral palsy.

Diagnosis of Yellow Bile Reflux

Researchers have developed different methods to investigate reflux in the stomach and esophagus. But until now, no definitive diagnosis of reflux disease exists.

The first and easiest method of diagnosis is to detect the presence of bile and then measure it. When there is reflux, a biochemical analysis can be used to identify the presence of bile in the liquid that refluxed into the esophagus. Bile should not be in the esophagus, and its presence is a symptom of bile reflux.

Treatment of Yellow Bile Reflux

Simple lifestyle changes can help you ease and manage bile reflux, including:

• Eat smaller but frequent meals.
• When lying down, ensure that your head is raised 10 to 20 cm so that food does not go back to your mouth from the stomach
• If you’re overweight, try to lose weight.
• Avoid stressful situations and try to relax as much as possible.
• Eat your evening meals 2 or 3 hours before going to bed.
• Avoid smoking and alcohol and also avoid the intake of secondary smoke whenever possible.
• Always seek a doctor’s advice before taking any medication.
• Drink plenty of clean water for hydration.

To be sure, always seek the advice and opinion of a qualified healthcare practitioner who can offer personalized treatment suggestions.

Show Sources

Annals of Palliative Medicine: “Understanding vomiting from the perspective of traditional Chinese medicine.”‌

British Medical Association: “Indigestion: When is it Functional?”

Comprehensive Physiology: “Bile Formation and Secretion.”

GASTROENTEROLOGY & HEPATOLOGY: “Management of Bile Reflux.”

Journal of clinical lipidology: “Balancing Cholesterol Synthesis and Absorption in the Gastrointestinal Tract.”

Journal of Gastrointestinal & Digestive System: “Stomach Bloating.”

Journal of Nuclear Medicine Technology: “Classification of Schema of Symptomatic Enterogastric Reflux Utilizing Sincalide Augmentation on Hepatobiliary Scintigraphy.”‌

Karger: “Bile Reflux into the Stomach and the Esophagus for Volunteers Older than 40 Years.”

Maastricht University: “Bile Reflux in GERD: Pathophysiological mechanism, clinical relevance, and therapeutic implications.”

Medicine: “Bile reflux gastritis cystica profunda.”

National Institute of Diabetes and Digestive Kidney Disease: “Acid Reflux (GER and GERD) in Adults.”

NHS Inform: “Vomiting in adults.”

VIVO Pathophysiology: “Secretion of Bile and the Role of Bile Acids in Digestion.”

World Journal of Gastroenterology: “Overlapping gastroesophageal reflux disease and irritable bowel syndrome: Increased dysfunctional symptoms.”

UNIVERSITY OF ROCHESTER MEDICAL CENTER: “Bile – not Acid – is Bad Guy in Triggering Precancerous Condition Associated with Reflux Disease.”

Why am I vomiting green or yellow bile?

Throwing up bile, a yellow or greenish liquid, can happen for many reasons, such as a high alcohol intake, pregnancy, bile reflux, or an intestinal blockage. Some of these may need urgent medical attention.

Someone who throws up bile should be aware of when to seek medical care and when vomiting bile can be relieved with home remedies.

Throwing up bile may be a sign of a serious problem.

Bile is the greenish-yellow liquid made by the liver and stored in the gallbladder. It aids food digestion by mainly breaking down fats and turning them into fatty acids.

Bile is made of the following:

• cholesterol
• salts
• bile acids
• bilirubin
• water
• certain metals

Vomiting bile can occur whenever a person throws up, and their stomach is empty. This can happen when someone has stomach flu or food poisoning and has already thrown up all the food in their stomach. It can also happen if a person has not eaten for many hours.

There is a range of other reasons why a person may throw up bile, including:

• binge drinking
• morning sickness
• bile reflux
• intestinal blockage

While many cases of vomiting bile have a clear cause, vomiting due to an intestinal blockage or other condition may be more difficult to determine.

Sometimes, determining the cause of throwing up bile is simple. For example, if a person has been drinking heavily and threw up bile afterward, the cause is likely to be excessive alcohol consumption.

However, looking at other symptoms can help determine the cause of throwing up bile in cases where the reason is less obvious.

Bile reflux

A doctor should be consulted to diagnose the cause of vomiting bile.

Bile reflux is not the same as acid reflux, though their symptoms are similar. Bile reflux occurs when bile backs up into a person’s stomach and esophagus.

Bile reflux often occurs after surgery, such as a gastric bypass or gallbladder removal, or because of peptic ulcers.

If a person vomits bile due to bile reflux, several other symptoms will likely occur, including:

• severe pain in the upper abdomen
• sour taste in the mouth
• frequent heartburn
• cough or hoarseness in the throat
• nausea
• weight loss

A person with symptoms of bile reflux should talk to a doctor. A doctor may be able to diagnose reflux based on a description of the symptoms alone. But they can also order further testing to determine whether it is bile reflux or acid reflux.

Proper diagnosis is crucial for treating bile reflux, as acid reflux treatments do not work for this condition.

Intestinal blockages

Intestinal blockages are a common cause of someone throwing up bile, but it may not be obvious to them that an intestinal blockage is to blame.

An intestinal blockage is serious and requires urgent medical attention to prevent complications, including sepsis, tissue death, and malnutrition.

A person who is throwing up bile should visit a doctor if they experience any of the following symptoms:

• waves of abdominal pain and cramps
• constipation
• loss of appetite
• swelling of the abdomen
• inability to pass gas

Symptoms of intestinal blockages may vary, depending on the underlying cause.

Intestinal blockages may be caused by any of the following:

• colorectal cancer
• other cancerous tumors
• a hernia
• diverticulitis or infection in the digestive tract
• gallstones
• impacted stool
• adhesions and scar tissue from surgery
• volvulus, otherwise known as twisted intestines
• inflammatory bowel disease (IBD)
• ileus, a condition that causes bowel problems

For adults, the two most common causes of bowel obstructions are colon cancer and adhesions or scar tissues that form in the intestines after abdominal or pelvic surgery.

A doctor can diagnose an intestinal blockage or obstruction by a physical exam and additional tests. Tests used to diagnose the cause of vomiting bile include:

For children under 3 years of age, the most common cause of intestinal blockage is a serious condition known as intussusception.

Intussusception happens when one part of the intestine slides into an adjacent section, similarly to the retraction of a telescope.

The condition causes pain that comes and goes at first before turning constant. The child may look very pale, tired, and limp, and may be vomiting.

Throwing up bile may not require medical attention if it has a clear cause and resolves with conservative methods, such as rest and rehydration. However, anyone who is persistently throwing up bile should see a doctor.

Anyone who is throwing up bile and has indications of bile reflux should see their doctor.

Similarly, people who are throwing up bile and have signs of dehydration should seek emergency medical care.

People should also see a doctor if they experience any of the following symptoms in addition to throwing up bile:

• chest pain
• unexplained weight loss
• severe abdominal pain
• inability to stop throwing up
• difficulty breathing
• vomit that looks like coffee grounds

Carers of a child under 3 years of age should seek immediate medical attention if the child has any of the following symptoms and is throwing up bile:

• complaining or crying in pain in waves
• blood or mucus in their stool
• lethargy
• diarrhea
• protrusion or lump in the abdomen
• fever

In a child under 3 years old, these symptoms may be a sign of intussusception.

Infants can become dehydrated very quickly and may need medical intervention to rehydrate much sooner than adults.

Surgery may be recommended if medication is not effective enough.

The treatment for vomiting bile will vary, depending on the cause. In cases of binge drinking or food poisoning, intravenous fluids in the hospital may be sufficient to treat the symptoms and prevent further complications.

In minor cases, resting and rehydrating with water and fluids containing electrolytes may be sufficient to relieve symptoms.

In cases of bile reflux, a doctor may prescribe medication to control the reflux. Two common types include:

• bile acid sequestrants
• ursodeoxycholic acid

If medications are not enough, a doctor may recommend surgical options, such as gastric bypass surgery. In this procedure, a new opening is created to the small intestine that prevents a buildup of bile in the stomach.

Similarly, other surgical options may help treat blockages or adhesions.

A surgeon may remove a portion of the intestine or the source of the blockage. They may also need to insert a stent to open a blockage and prevent further blockages.

In cases of cancer, a doctor will need to assess how far the disease has spread to decide the treatment. Typical treatments for cancer include:

• chemotherapy
• surgery
• radiation
• other targeted therapies

It is not always possible to prevent a person vomiting bile. However, lifestyle changes can avoid some of the most common causes, such as drinking alcohol to excess or poor diet choices.

To help prevent vomiting bile, a person can:

• limit their alcohol intake and avoid binge drinking
• not lift heavy objects to avoid the risk of a hernia
• get regular colonoscopies if recommended by a doctor
• avoid smoking tobacco
• eat a variety of fruits and vegetables
• eat foods high in fiber to help prevent diverticulitis
• avoid uncooked or potentially contaminated foods

A person’s overall outlook depends largely on the reason why they are throwing up bile. In acute cases, such as after a night of drinking or a bout of food poisoning, a person will likely make a full recovery with minor treatments.

People with underlying medical conditions may also experience a full recovery, but treatment will vary based on the condition.

Anyone experiencing unexplained or persistent vomiting should see a doctor for a proper diagnosis and to avoid complications.

Last medically reviewed on January 3, 2020