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{{short description|Involuntary, forceful expulsion of stomach contents, typically via the mouth}}
{{Distinguish|Regurgitation (digestion)}}
{{Redirect-multi|5|Vomit|Emesis|Heaving|Puke|Throw up|other uses|Vomit (disambiguation)|the butterfly genus|Emesis (genus)|the 2021 Argentine film|PussyCake|the sailing terms|Heaving to|and|Careening|the municipality of Albania|Pukë|the style of graffiti|Throw up (graffiti)|other uses|Puke (disambiguation)}}
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{{Sprotect|small=yes}}
{{Infobox medical condition (new)
| name = Vomiting
| synonyms = Emesis, throwing up, puking, barfing, spewing, upchucking, heaving,
| image = File:49-aspetti di vita quotidiana, vomito,Taccuino Sanitatis, Ca.jpg
| alt = A Renaissance drawing with vivid colours depicting a woman holding the head of a man, who is bent over and expelling a brownish-red material from his mouth. A second woman stands at the left of the image in the doorway to the room, and appears to offer support. A crude representation of vomiting.
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}}
<!-- Definition and description -->
'''Vomiting''' (also known as '''emesis''', '''puking''' and '''throwing up'''){{efn|
<!-- Cause -->
Vomiting can be the result of ailments like
==Complications==
[[File:Symptoms-vomiting.jpg|thumb|Vomiting]]
===Aspiration===
Vomiting is dangerous if gastric content enters the [[respiratory tract]]. Under normal circumstances the [[gag reflex]] and [[coughing]] prevent this from occurring; however, these protective reflexes are compromised in persons who are under the influence of certain substances (including [[ethanol|alcohol]]) or even mildly [[anesthesia|anesthetized]]. The individual may choke and [[asphyxiation|asphyxiate]]<ref>{{cite book |last1=Robson |first1=Philip |title=Forbidden Drugs |date=1999 |publisher=Oxford University Press |location=New York |isbn=0-19-262955-7 |page=49 |edition=2nd |url=https://
===Dehydration and electrolyte imbalance===
Prolonged and excessive vomiting depletes the body of [[water]] ([[dehydration]]), and may alter the [[electrolyte]] status. Gastric vomiting leads to the loss of acid (protons) and chloride directly. Combined with the resulting [[alkaline tide]], this leads to [[hypochloremia|hypochloremic]] [[metabolic alkalosis]] (low [[chloride]] levels together with high {{chem|link=bicarbonate|HCO|3|-}} and {{chem|CO|2}} and increased blood [[pH]]) and often [[hypokalemia]] ([[potassium]] depletion). The hypokalemia is an indirect result of the [[kidney]] compensating for the loss of acid. With the loss of intake of food the individual may eventually become [[cachexia|cachectic]]. A less frequent occurrence results from a vomiting of intestinal contents, including bile acids and {{chem|HCO|3|-}}
===Mallory–Weiss tear===
{{see also|Mallory–Weiss syndrome}}
Repeated or profuse vomiting may cause erosions to the [[esophagus]] or small tears in the esophageal mucosa ([[Mallory–Weiss syndrome|Mallory–Weiss tear]]). This may become apparent if fresh red blood is mixed with vomit after several episodes.
===Dentistry===
Recurrent vomiting, such as observed in [[bulimia nervosa]], may lead to the destruction of the [[tooth enamel]] due to the acidity of the vomit. [[Digestive enzyme]]s can also have a negative effect on oral health, by degrading the tissue of the [[gums]].
==Pathophysiology==
Receptors on the floor of the [[fourth ventricle]] of the brain represent a [[chemoreceptor trigger zone]], known as the [[area postrema]], stimulation of which can lead to vomiting.<ref name=hauser/> The area postrema is a [[circumventricular organ]] and as such lies outside the [[blood–brain barrier]]; it can therefore be stimulated by blood-borne drugs that can [[Emetic|stimulate vomiting]] or [[Antiemetics|inhibit it]].<ref>{{cite book|last1=Holland|first1=James F.|last2=Kufe|first2=Donald W.|last3=Weichselbaum|first3=Ralph R.|last4=Pollock|first4=Raphael E.|last5=Frei III|first5=Emil|last6=Gansler|first6=Ted S.|last7=Bast Jr.|first7=Robert C.|title=Cancer medicine|date=2003|publisher=Decker|location=Hamilton, Ontario [u.a.]|isbn=
▲Receptors on the floor of the [[fourth ventricle]] of the brain represent a [[chemoreceptor trigger zone]], known as the [[area postrema]], stimulation of which can lead to vomiting. The area postrema is a [[circumventricular organ]] and as such lies outside the [[blood–brain barrier]]; it can therefore be stimulated by blood-borne drugs that can [[Emetic|stimulate vomiting]] or [[Antiemetics|inhibit it]].<ref>{{cite book|last1=Holland|first1=James F.|last2=Kufe|first2=Donald W.|last3=Weichselbaum|first3=Ralph R.|last4=Pollock|first4=Raphael E.|last5=Frei III|first5=Emil|last6=Gansler|first6=Ted S.|last7=Bast Jr.|first7=Robert C.|title=Cancer medicine|date=2003|publisher=Decker|location=Hamilton, Ontario [u.a.]|isbn=9781550092134|edition=6. [ed.].|url=https://archive.org/details/cancermedicine60002unse|url-access=registration}} <!--Verify page--></ref>
There are various sources of input to the vomiting center:
* The chemoreceptor trigger zone at the base of the fourth ventricle has numerous [[dopamine receptors|dopamine D<sub>2</sub> receptors]], [[5-HT receptor|serotonin 5-HT<sub>3</sub> receptors]], [[opioid receptor]]s, [[acetylcholine receptor]]s, and receptors for [[substance P]]. Stimulation of different receptors are involved in different pathways leading to emesis, in the final common pathway substance P appears involved.<ref>{{cite journal | last1 = Hornby | first1 = PJ | title = Central neurocircuitry associated with emesis | journal = The American Journal of Medicine | volume = 111 Suppl 8A | pages = 106S–112S | year = 2001 | pmid = 11749934 | doi=10.1016/S0002-9343(01)00849-X | issue = 8}}</ref><ref name="pmid8129158">{{cite journal|last1=Naylor|first1=RJ|last2=Inall|first2=FC|title=The physiology and pharmacology of postoperative nausea and vomiting.|journal=Anaesthesia|date=January 1994|volume=49 Suppl|pages=2–5|pmid=8129158|doi=10.1111/j.1365-2044.1994.tb03575.x|doi-access=free}}</ref>
* The [[vestibular system]], which sends information to the brain via [[cranial nerve VIII]] (vestibulocochlear nerve), plays a major role in [[motion sickness]], and is rich in [[Muscarinic acetylcholine receptor|muscarinic receptors]] and [[histamine receptor|histamine H<sub>1</sub> receptors]].<ref name="pmid6399658">{{cite journal|last1=Matsuoka|first1=I|last2=Ito|first2=J|last3=Takahashi|first3=H|last4=Sasa|first4=M|last5=Takaori|first5=S|title=Experimental vestibular pharmacology: a minireview with special reference to neuroactive substances and antivertigo drugs.|journal=Acta Oto-Laryngologica Supplementum|date=1984|volume=419|pages=62–70|pmid=6399658}}</ref><ref>{{cite journal|last1=Li–gui|first1=Huang|last2=En–tong|first2=Wang|last3=Wei|first3=Chen|last4=Wei–xi|first4=Gong|title=Role of Histamine H1 Receptors in Vestibular Nucleus in Motion Sickness|journal=Journal of Otology|date=June 2011|volume=6|issue=1|pages=20–25|doi=10.1016/S1672-2930(11)50003-0|doi-access=free}}</ref>
* The [[vagus nerve|cranial nerve X]] ([[vagus nerve]]) is activated when the [[pharynx]] is irritated, leading to a [[Pharyngeal reflex|gag reflex]].
* The vagal and [[enteric nervous system]] inputs transmit information regarding the state of the [[gastrointestinal system]]. Irritation of the GI mucosa by [[chemotherapy]], [[radiation]], distention, or acute infectious [[gastroenteritis]] activates the 5-HT<sub>3</sub> receptors of these inputs.
* The [[Central nervous system|CNS]] mediates vomiting that arises from psychiatric disorders and stress from higher brain centers.<ref>{{cite journal |author1=Ray Andrew P. |author2=Chebolu Seetha |author3=Ramirez Juan |author4=Darmani Nissar A | year = 2009 | title = Ablation of Least Shrew Central Neurokinin NK1 Receptors Reduces GR73632-Induced Vomiting | journal = Behavioral Neuroscience | volume = 123 | issue = 3| pages = 701–706 | doi = 10.1037/a0015733 |pmid=19485577 |pmc=2714262 }}</ref>
* The [[Medulla oblongata|medulla]] plays an important role for triggering the vomiting act.<ref name=newrev2017>{{cite journal | vauthors = Balaban CD, Yates BJ | title = What is nausea? A historical analysis of changing views | journal = Autonomic Neuroscience | volume = 202 | pages = 5–17 | date = January 2017 | pmid = 27450627 | doi = 10.1016/j.autneu.2016.07.003 | pmc = 5203950 }}</ref>
The vomiting act encompasses three types of outputs initiated by the chemoreceptor trigger zone: Motor, [[parasympathetic nervous system]] (PNS), and [[sympathetic nervous system]] (SNS). They are as follows:
* Increased [[saliva]]tion to protect [[tooth enamel]] from stomach acids.<ref name="Mechanisms of nausea and vomiting">{{cite book |author1=Anthony L. Kovac |editor1-last=Tong Joo Gan |editor2-last=Habib |editor2-first=Ashraf S. |title=Postoperative Nausea and Vomiting: A Practical Guide |date=March 29, 2016 |publisher=Cambridge University Press |location=Cambridge, United Kingdom |isbn=978-1-107-46519-0 |page=13 |chapter-url=https://
* The body takes a deep breath to avoid [[Pulmonary aspiration|aspirating]] vomit.<ref name="Mechanisms of nausea and vomiting"/>
* [[Retroperistalsis]] starts from the middle of the [[small intestine]] and sweeps up digestive tract contents into the stomach, through the relaxed [[pylorus|pyloric sphincter]].<ref name="Mechanisms of nausea and vomiting"/>
* Intrathoracic pressure lowers (by [[Inhalation|inspiration]] against a closed [[glottis]]), coupled with an increase in abdominal pressure as the [[abdomen|abdominal muscles]] contract, propels stomach contents into the [[esophagus]] as the [[cardia|lower esophageal sphincter]] relaxes.<ref>{{cite book |last1=Boarder |first1=Michael |last2=Dixon |first2=Jane |last3=Newby |first3=David |last4=Navti |first4=Phyllis |last5=Zetterström |first5=Tyra |title=Pharmacology for Pharmacy and the Health Sciences: A Patient-Centred Approach |date=2017 |publisher=Oxford University Press |location=New York, NY |isbn=978-0-19-107072-3 |page=317 |edition=2nd |url=https://
* Vomiting is ordinarily preceded by [[retching]].<ref name="Mechanisms of nausea and vomiting"/>
* Vomiting also initiates an [[Sympathetic nervous system|SNS]] response causing both sweating and increased heart rate.<ref name="Mechanisms of nausea and vomiting"/>
=== Phases ===▼
▲=== Phases ===
The vomiting act has two phases. In the '''retching phase''', the abdominal muscles undergo a few rounds of coordinated contractions together with the diaphragm and the muscles used in respiratory inspiration. For this reason, an individual may confuse this phase with an episode of violent [[hiccups]]. In this retching phase, nothing has yet been expelled. In the next phase, also termed the '''expulsive phase''', intense pressure is formed in the stomach brought about by enormous shifts in both the diaphragm and the abdomen. These shifts are, in essence, vigorous contractions of these muscles that last for extended periods of time—much longer than a normal period of muscular contraction. The pressure is then suddenly released when the upper esophageal sphincter relaxes resulting in the expulsion of gastric contents. As the mouth and [[nasal cavity]] are connected via the back of the throat, particularly forceful vomiting, or producing large quantities of vomit may result in material being ejected through the [[nostril]]s in addition to the mouth. Individuals who do not regularly exercise their abdominal muscles may experience pain in those muscles for a few days. The
===Contents===
[[File:Vomit of partially digested food in a 11 litre container Man-sized glove is shown in photo for scale.jpg|thumb|Partially digested food, with
[[Gastric acid|Gastric secretions]] and likewise vomit are highly [[acid]]ic. Recent food intake appears in the gastric vomit. Irrespective of the content, vomit tends to be [[odor|malodorous]].{{citation needed|date=June 2015}}
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If the vomiting reflex continues for an extended period with no appreciable vomitus, the condition is known as non-productive emesis or "dry heaves", which can be painful and debilitating.{{citation needed|date=June 2015}}
;Color of vomit<ref>{{Cite journal|last=W. S.|first=CRAIG|date=1961|title=Vomiting in the early days of life.|journal=Archives of Disease in Childhood|volume=36|issue=188|
* Bright red in the vomit suggests bleeding from the esophagus
* Dark red vomit with liver-like clots suggests profuse bleeding in the stomach, such as from a perforated ulcer
* Coffee-ground-like vomit suggests less severe bleeding in the stomach because the gastric acid has had time to change the composition of the blood
* Yellow or green vomit suggests bile, indicating that the [[pyloric valve]] is open and bile is flowing into the stomach from the duodenum.
==Causes==
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===Digestive tract===
Causes in the [[digestive tract]]
* [[Gastritis]] ([[inflammation]] of the
* [[Gastroenteritis]]
* [[Gastroesophageal reflux disease]]
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* [[Cholecystitis]], [[pancreatitis]], [[appendicitis]], [[hepatitis]]
* [[Food poisoning]]
* In children, it can be caused by an [[allergic reaction]] to cow's [[milk proteins]] ([[
===Sensory system and brain===
Causes in the [[sensory system]]:{{citation needed|date=June 2015}}
* Movement leading to [[motion sickness]] (which is caused by overstimulation of the labyrinthine [[Ear canal|canals of the ear]]){{citation needed|reason=Is learned response to vestibular input not the cause?|date=June 2015}}
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* [[Concussion]]
* [[Cerebral hemorrhage]]
* [[Intracranial aneurysm|Cerebral aneurysm]]
* [[Migraine]]
* [[Brain tumor]]s, which can cause the chemoreceptors to malfunction
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* [[Hyperglycemia]]
[[Pregnancy]]:<ref>{{Cite journal
* [[Hyperemesis gravidarum|Hyperemesis]], [[morning sickness]]
[[Drug reaction]] (vomiting may occur as an acute [[Somatic (biology)|somatic]] response to):{{citation needed|date=June 2015}}
* [[alcohol (drug)|Alcohol]], which can be partially oxidized into [[acetaldehyde]] that causes the symptoms of [[hangover]], including nausea, vomiting, shortness of breath, and fast heart rate.<ref>{{cite book |editor1-last=Rostron |editor1-first=Chris |editor2-last=Barber |editor2-first=Jill |title=Pharmaceutical Chemistry |date=March 2021 |publisher=Oxford University Press |location=New York, NY |isbn=978-0-19-877978-0 |page=8 |edition=2nd |url=https://
* [[Opioid]]s
* [[Selective serotonin reuptake inhibitor]]s
* Many [[chemotherapy]] drugs
* Some [[entheogen]]s (such as [[peyote]] or [[ayahuasca]])
[[Effects of high altitude on humans|High altitude]]:
*[[Altitude sickness]]<ref name=Fer2016>{{cite book |vauthors=Ferri FF |title=Ferri's Clinical Advisor 2017 E-Book: 5 Books in 1 |date=2016 |publisher=Elsevier Health Sciences |isbn=978-0-323-44838-3 |page=590 |url=https://books.google.com/books?id=rRhCDAAAQBAJ&pg=PA590 |language=en |access-date=2023-01-02 |archive-date=2023-12-28 |archive-url=https://web.archive.org/web/20231228075055/https://books.google.com/books?id=rRhCDAAAQBAJ&pg=PA590#v=onepage&q&f=false |url-status=live }}</ref>
[[Illness]] (sometimes colloquially known as "[[stomach flu]]"—a broad name that refers to gastric inflammation caused by a range of viruses and bacteria):{{citation needed|date=June 2015}}
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Psychiatric/behavioral:
* [[Bulimia nervosa]]
* [[Food neophobia]]
* [[Purging disorder]]
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Emetics can be divided into two categories, those which produce their effect by acting on the vomiting center in the medulla, and those which act directly on the stomach itself. Some emetics, such as ipecac, fall into both categories; they initially act directly on the stomach, while their further and more vigorous effect occurs by stimulation of the medullary center.<ref name="EB1911">{{EB1911|inline=y|wstitle=Emetics|volume=9|page=336}}</ref>
[[Salt]] water and [[Mustard seed|mustard]] water, which act directly on the stomach, have been used since ancient times as emetics.<ref>{{cite journal | doi = 10.3109/15563657108990490 | last1 = Decker | first1 = W. J. | year = 1971 | title = In Quest of Emesis: Fact, Fable, and Fancy | journal = Clinical Toxicology | volume = 4 | issue = 3| pages = 383–387 | pmid = 4151103 }}</ref> Care must be taken with salt, as [[Hypernatremia|excessive intake can potentially be harmful]].<ref>{{cite journal | last1 = Moder | first1 = K. G. | last2 = Hurley | first2 = D. L. | year = 1991 | title = Fatal hypernatremia from exogenous salt intake: report of a case and review of the literature | journal = Mayo Clinic Proceedings | volume = 65 | issue = 12| pages = 1587–94 | pmid = 2255221 | doi = 10.1016/S0025-6196(12)62194-6 | doi-access =
[[Copper(II) sulfate|Copper sulfate]] was also used in the past as an emetic.<ref name="pmid4385403">{{cite journal |vauthors=Holtzmann NA, Haslam RH |title=Elevation of serum copper following copper sulfate as an emetic |journal=Pediatrics |volume=42 |issue=1 |pages=189–93 |date=July 1968 |doi=10.1542/peds.42.1.189 |pmid=4385403 |s2cid=32740524 |url=http://pediatrics.aappublications.org/cgi/content/abstract/42/1/189 |access-date=2009-03-06 |archive-date=2010-06-16 |archive-url=https://web.archive.org/web/20100616094559/http://pediatrics.aappublications.org/cgi/content/abstract/42/1/189
[[Hydrogen peroxide]] is used as an emetic in veterinary practice.<ref>{{cite encyclopedia|title=Drugs to Control or Stimulate Vomiting|encyclopedia=Merck Veterinary manual|url=http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/190303.htm|publisher=[[Merck & Co.]], Inc|year=2006|access-date=2013-02-23|archive-date=2016-03-24|archive-url=https://web.archive.org/web/20160324233045/http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm%2Fbc%2F190303.htm|url-status=live}}</ref><ref>{{cite web |url=http://www.petplace.com/dogs/how-to-induce-vomiting-emesis-in-dogs/page1.aspx |title=How to Induce Vomiting (Emesis) in Dogs |publisher=Petplace.com |access-date=2014-05-03 |archive-date=2015-02-12 |archive-url=https://web.archive.org/web/20150212010816/http://www.petplace.com/dogs/how-to-induce-vomiting-emesis-in-dogs/page1.aspx
===Self-induced===
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* To eliminate an ingested poison (some poisons should not be vomited as they may be more toxic when inhaled or aspirated; it is better to ask for help before inducing vomiting)
* Some people who engage in [[binge drinking]] induce vomiting to make room in their stomachs for more alcohol consumption.
* Participants
* People suffering from [[nausea]] may induce vomiting in hopes of feeling better.
===
* After [[surgery]] ([[postoperative nausea and vomiting]])
* Disagreeable sights or [[disgust]], smells, tastes, sounds or thoughts (such as decayed matter, others' vomit, thinking of vomiting), etc.
* Extreme pain, such as an intense [[headache]] or [[myocardial infarction]] (heart attack)
* Extreme [[emotions]]<!-- "Violent" could be misinterpreted here. -->
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* [[Depression (mood)|Depression]]
* [[Overexertion]] (doing too much strenuous exercise can lead to vomiting shortly afterwards).
===Other types===
* ''Projectile vomiting'' is vomiting that ejects the gastric contents with great force.<ref name=med_dict>{{cite web |url=http://medical-dictionary.thefreedictionary.com/vomiting |title=vomiting - definition of vomiting in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia |publisher=Medical-dictionary.thefreedictionary.com |access-date=2014-05-03 |archive-date=2014-02-22 |archive-url=https://web.archive.org/web/20140222155353/http://medical-dictionary.thefreedictionary.com/vomiting |url-status=live }}</ref> It is a classic symptom of [[pyloric stenosis|infantile hypertrophic pyloric stenosis]], in which it typically follows feeding and can be so forceful that some material exits through the nose.<ref name=Sleisenger783>{{cite book
==Treatment==
An [[antiemetic]] is a [[medication|drug]] that is effective against vomiting and [[nausea]]. Antiemetics are typically used to treat [[motion sickness]] and the [[Adverse effect (medicine)|side effects]] of medications such as [[opioid]]s and [[chemotherapy]].
Antiemetics act by inhibiting the receptor sites associated with emesis. Hence, anticholinergics, antihistamines, dopamine antagonists, serotonin antagonists, and cannabinoids are used as antiemetics.<ref>{{cite journal|last1=Mitchelson|first1=F|title=Pharmacological agents affecting emesis. A review (Part I).|journal=Drugs|date=March 1992|volume=43|issue=3|pages=295–315|pmid=1374316|doi=10.2165/00003495-199243030-00002|s2cid=46983160}}</ref>
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==Epidemiology==
[[Nausea]] and/or vomiting are the main complaints in 1.6% of visits to family physicians in Australia.<ref>{{cite journal |author=Helena Britt |last2=Fahridin |first2=S |title=Presentations of nausea and vomiting |journal=Australian Family Physician |volume=36 |issue=9 |pages=673–784 |date=September 2007 |pmid=17885697 |url=http://www.racgp.org.au/afp/200709/200709beach.pdf |access-date=2010-02-15 |archive-date=2019-03-26 |archive-url=https://web.archive.org/web/20190326113722/https://www.racgp.org.au/afp/200709/200709beach.pdf
==Society and culture==
[[Herodotus]], writing on the culture of the [[Achaemenid Empire|ancient Persians]] and highlighting the differences with those of the [[Ancient Greece|Greeks]], notes that to vomit in the presence of others is prohibited among Persians.<ref>{{cite web|url=http://www.iranicaonline.org/articles/herodotus-iii|title=HERODOTUS iii. DEFINING THE PERSIANS – Encyclopaedia Iranica|last=electricpulp.com|website=www.iranicaonline.org|access-date=2017-06-24|archive-date=2019-01-29|archive-url=https://web.archive.org/web/20190129214830/http://www.iranicaonline.org/articles/herodotus-iii|url-status=live}}</ref><ref>{{cite web|url=http://sourcebooks.fordham.edu/ancient/herodotus-persians.asp|title=Internet History Sourcebooks|website=sourcebooks.fordham.edu|access-date=2017-06-24|archive-date=2017-07-07|archive-url=https://web.archive.org/web/20170707040138/http://sourcebooks.fordham.edu/ancient/herodotus-persians.asp|url-status=live}}</ref>
===Social cues===
[[File:Nationalmuseet - Cophenaghen - brygos vomiting1.jpg|thumb|A drunk man vomiting, while a young slave is holding his forehead. [[Brygos Painter]], 500–470 BC]]
It is quite common that, when one person vomits, others nearby become nauseated, particularly when smelling the vomit of others, and often to the point of vomiting themselves. It is believed that this is an [[evolution|evolved]] trait among [[primate]]s. Many primates in the wild tend to browse for food in small groups. Should one member of the party react adversely to some ingested food, it may be advantageous (in a survival sense) for other members of the party to also vomit. This tendency in human populations has been observed at drinking parties, where excessive consumption of [[alcoholic beverage]]s may cause a number of party members to vomit nearly simultaneously, this being triggered by the initial vomiting of a single member of the party. This phenomenon has been touched on in popular culture: notorious instances appear in the films ''[[Mr Creosote|Monty Python's The Meaning of Life]]'' (1983) and ''[[Stand by Me (film)|Stand
Intense vomiting in [[ayahuasca]] [[ceremony|ceremonies]] is a common phenomenon. However, people who experience "la purga" after drinking ayahuasca, in general, regard the practise as both a physical and spiritual cleanse and often come to welcome it.<ref>Shanon, B. (2002). The antipodes of the mind: Charting the phenomenology of the ayahuasca experience. Oxford: Oxford University Press.</ref> It has been suggested that the consistent emetic effects of ayahuasca—in addition to its many other therapeutic properties—was of medicinal benefit to [[indigenous people]]s of the [[Amazon Basin|Amazon]], in helping to clear [[parasite]]s from the gastrointestinal system.<ref>{{cite journal | last1 = Andritzky | first1 = W. | year = 1989 | title = Sociopsychotherapeutic functions of ayahuasca healing in Amazonia | journal = Journal of Psychoactive Drugs | volume = 21 | issue = 1| pages = 77–89 | pmid = 2656954 | doi=10.1080/02791072.1989.10472145}}</ref>
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People who vomit chronically (e.g., as part of an [[eating disorder]] such as [[bulimia nervosa]]) may devise various ways to hide this disorder.{{citation needed|date=June 2015}}
An online study of people's responses to "horrible sounds" found vomiting "the most disgusting". Professor Trevor Cox of the [[University of Salford]]'s Acoustic Research Centre said, "We are pre-programmed to be repulsed by horrible things such as vomiting, as it is fundamental to staying alive to avoid nasty stuff." It is thought that [[disgust]] is triggered by the sound of vomiting to protect those nearby from possibly diseased food.<ref>[http://www.salford.ac.uk/news/details/462 "Sickening sounds - research to make your ears cringe"]. [[University of Salford]]. January 28, 2007. {{webarchive|url=https://web.archive.org/web/20090224205900/http://www.salford.ac.uk/news/details/462|date=February 24, 2009}}</ref>
===Psychology===
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* [[Nose-blowing]]
* [[Belching]]
* [[Chyme]]
==Notes==
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