Intractable vomiting is the forceful emptying of the stomach that does not respond to the usual methods of treatment. Persistent vomiting can quickly lead to dehydration, and malnutrition or even starvation can occur if the condition is not controlled. Intractable vomiting can be a symptom of numerous illnesses, many of which are serious, so a patient should consult with his or her healthcare professional to determine the cause. After the underlying cause is understood, the doctor can choose from a variety of options for treatment-resistant vomiting. The possible treatments for persistent vomiting include medication, the administering of intravenous fluids, surgery, acupressure and acupuncture.
In pregnant women, intractable vomiting is referred to as hyperemesis gravidarum. Higher hormone levels during pregnancy typically are associated with nausea and vomiting. A woman who is pregnant with twins is more prone to this condition because her hormone levels are approximately twice that of a pregnant woman who is carrying a single fetus. Hyperemesis gravidarum is not the same as morning sickness, which typically is associated with a particular time or with food intake.
If a pregnant patient suffers from treatment-resistant vomiting, her doctor probably will admit her to the hospital. There, all oral intake of food and fluids is stopped. Intravenous (IV) fluids are administered to provide nourishment. The IV might include folic acid and a range of vitamin B supplements.
Persistent vomiting also can result from an intestinal blockage. Scar tissue might form after abdominal surgery, the intestine can become twisted because of an injury, or abnormal growths might appear in the intestines. Treatment typically involves surgery to remove the blockage.
Some patients vomit in response to signals received from the brain. The signals might be sensory, such as smells, or might be a reaction to chemicals in the blood, such as certain medications. Vomiting might stop if the source of the signals can be eliminated or blocked. With medications, a different drug or dosage might be helpful. The doctor might also prescribe drugs that block the signals sent by the brain.
Chemotherapy can cause intractable vomiting, particularly among patients who are receiving cisplastin combination chemotherapy. It might be inadvisable to alter the patient's treatment, so the doctor might opt for a regimen of drugs to control the vomiting. Commonly used medications include diphenhydramine, diazepam, metoclopramide, thiethylperazine and dexamethasone.
Acupressure and acupuncture are sometimes recommended as alternatives to traditional medicine. Meditation might benefit some patients whose vomiting is caused by anxiety or stress. As of 2011, limited scientific studies had been conducted on acupressure, acupuncture and meditation, and the results were mixed. Some patients reported significant improvement, but others achieved little or no relief. Reassuring the patient, making sure that he or she is comfortable and other types of supportive care might produce results as well.