Vomiting: What Happens in Your Stomach? - Internal Medicine

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Vomiting is a complex physiological process that involves the coordinated action of various muscles and neural pathways. When you experience nausea and the urge to vomit, your body is responding to a variety of stimuli, which can include irritation of the stomach lining, motion sickness, or even psychological factors such as stress or anxiety.
To address your first question regarding the order of food that is expelled during vomiting: when vomiting occurs, the contents of the stomach are expelled through the esophagus and out of the mouth. Typically, the food that is expelled first is the material that is closest to the esophagus, which is usually the food that was ingested most recently. This means that if you have just eaten a meal, the food that is at the top of the stomach (the upper part) is more likely to be vomited first. The food that has been in the stomach longer, which is more thoroughly mixed and broken down into a semi-liquid form known as chyme, is generally located deeper in the stomach and may not be expelled until the upper contents are cleared.

In the scenario you described, where you have food that has already been processed into chyme at the bottom of the stomach and new food on top, it is indeed more challenging to vomit only the bad food without also expelling the newer food. This is because the act of vomiting is not selective; it tends to expel whatever is present in the stomach at the time of the reflex. Therefore, if you were to induce vomiting to remove the bad food, you would likely also expel the newer food that is sitting above it.

If you suspect that you have ingested something harmful, it is crucial to approach the situation carefully. Inducing vomiting is not always recommended, especially if the ingested substance is caustic or if there is a risk of aspiration (inhaling vomit into the lungs). In such cases, it is best to seek medical attention immediately. Healthcare professionals can provide appropriate interventions, which may include administering activated charcoal to absorb toxins or other treatments based on the specific situation.

In summary, when vomiting occurs, the contents expelled are typically those that are closest to the esophagus, which are usually the most recently ingested items. If you are trying to remove something that has already been processed in the stomach, it is likely that you will also expel the newer food on top. If you are experiencing persistent nausea or vomiting, or if you suspect food poisoning, it is advisable to consult a healthcare provider for further evaluation and management.