Does Anxiety Make You Throw Up
Does Anxiety Make You Throw Up? You’re driving to work when you start feeling queasy. Or maybe it’s after dinner on a night when you’ve overdone your alcohol intake. Maybe you just got back from vacation where you ate something that didn’t agree with you or took some medicine that made you feel bad. Whatever the reason is, you’re suddenly overcome by nausea and/or dizziness. And before you know what’s happening, you’re throwing up all over your car seat and getting sicker as each wave comes out.
It sounds awful, but this kind of episode isn’t uncommon among people who have general anxiety disorders (GAD). It’s known medically as emesis gravis, a term for severe cases of nausea and vomiting. The causes are many and varied, including stress, eating too much spicy food, taking certain medications, being pregnant and having heartburn. But one thing most episodes have in common is cyclical vomiting. That’s because they tend to occur roughly around the same time every day and sometimes even during specific activities like exercise. People who suffer from these types of episodes are said to be suffering from “daily” or “seasonal” vomiting disorder.
Cyclical vomiting syndrome (CVS) affects about 1 percent of children and adolescents between the ages of 6 and 16 years old. CVS may begin in childhood, although it tends to show itself more commonly in teenagers. A person might not realize he has CVS until he sees his doctor, but doctors believe there could be clues in the patient’s behavior. For instance, if someone were to ask him how long he spent throwing up, he would probably say several hours; however, when asked how many times he had done so already that day, he’d respond with multiple answers depending on whether he was lying.
The symptoms of CVS vary widely based on the individual. Some sufferers vomit only once in a while while others may do so every hour. In either case, though, no matter how infrequent, the vomiting is usually accompanied by nausea. Also, the stomach pain associated with CVS can be extremely intense.
In addition to its severity, another characteristic of CVS is that it doesn’t seem to go along with any particular lifestyle. No one seems to be able to pinpoint exactly why it happens. However, studies have shown that stress plays a role.
Next we’ll look specifically at how stress can cause vomiting.
Causes of Cyclic Vomiting Syndrome
There are two main theories behind why people get CVS. One asserts that the syndrome is caused by the brain releasing chemicals such as prolactin, vasoactive intestinal polypeptide (VIP), substance P and somatostatin into the bloodstream. This release occurs whenever a person feels threatened. These chemical signals tell the body to secrete fluids through the lining of the stomach and intestines. That results in nausea and vomiting, both of which help protect us against poisoning. When the threat subsides, the secretion stops.
Another theory proposes that CVS is brought on by abnormal levels of serotonin. Serotonin is a neurotransmitter that helps regulate sleep, appetite and mood. Too little serotonin can result in depression-like behaviors while too much can lead to agitation and paranoia. It’s thought that the increased amount of serotonin released into the bloodstream when a person gets anxious leads to higher gastric secretions, causing problems with emptying the stomach.
Both theories have yet to be proven definitively since research into CVS is still relatively new. What is known, however, is that stress is one of the leading triggers of CVS.
If you think you might have CVS, talk to your doctor. He will likely want to rule out other conditions like diabetes or irritable bowel disease (IBS). Other possibilities include drugs like antidepressants, tranquilizers, amphetamines, steroids and beta-blockers. If you take any of those medications, you should consult your physician about stopping them temporarily or permanently. Additionally, if you smoke cigarettes, quit immediately. Smoking increases the risk of gastrointestinal bleeding, which can ultimately increase the likelihood of CVS.
Treatment for Cylic Vomiting Syndrome
There are few treatment options available for CVS. Most patients are simply told to avoid situations that make them anxious. They may also use antispasmodics to relieve muscle contractions in the gut which are believed to exacerbate the problem. Doctors will prescribe medications designed to control nausea and vomiting, especially antiemetics, which reduce the discomfort of nausea. Medications used to treat CVS include metoclopramide, domperidone, prochlorpromazine (also known as Prozac) and chlorpheniramine.
Some patients find relief using acupuncture, biofeedback therapy or hypnotherapy. There is also evidence that acupuncture works well in conjunction with medication to control CVS.
Finally, surgery may be considered for some people. Doctors may remove part of the small intestine through which some substances pass into the blood stream. The procedure, called jejunectomy, reduces the absorption of offending compounds. Surgery alone may not work for everyone, though, so it is recommended that patients try to identify other ways to manage their anxiety first.
Now that we understand what CVS is, let’s see what the connection is between GAD and CVS.
Anxiety Disorders and Cyclic Vomiting Syndrome
Although the exact reasons aren’t fully understood, people who suffer from generalized anxiety disorders (GAD) are almost twice as likely to develop cyclic vomiting syndrome than those without it. Between 15 and 30 percent of people diagnosed with GAD will eventually develop CVS.
A study conducted in 2007 found that women with GAD are particularly susceptible to developing CVS. Researchers discovered that estrogen might play a role in triggering CVS in women with GAD. Estrogen appears to stimulate the release of VIP and serotonin, which are both involved in the process of nausea and vomiting. Women who experienced CVS were significantly less stressed than women who did not experience CVS. Since females typically have lower levels of stress hormones than males, it stands to reason that hormonal changes can affect the balance of CVS-related chemicals in the body.
Researchers haven’t been able to determine why CVS develops in some people and not others. Stress does appear to play a major role, but scientists don’t know exactly how. Studies indicate that genetics may also contribute to the development of CVS. Some researchers theorize that inheritable genes influence the way the brain handles signaling between neurons and receptors.
Scientists hope that further understanding of the link between CVS and GAD will allow them to develop better treatments and preventative measures.