Vomiting of bile during pregnancy

Pregnant women are often plagued by nausea and vomiting at the beginning of their pregnancy. About 0.5 to 1% of women show severe courses of pregnancy vomiting (hyperemesis gravidarum). This refers to the insatiable morning sickness during pregnancy.

The mild form of the disease is called Emesis gravidarum and affects many women. It occurs mainly in the first 3 months of pregnancy and usually subsides by the 20th week of pregnancy. Pregnant women vomit very often, even on an empty stomach, which is why it is often said that they vomit “until the bile comes”. However, it is usually only the stomach contents and not the bile.

Diagnosis

Your physician, for example your family doctor or an internist, can narrow down the causes of bilious vomiting by asking specific questions (anamnesis) about important accompanying symptoms or life circumstances. The doctor will ask about previous diseases of the small intestine, liver, gall bladder and other organ systems. The consumption of alcohol and the regular intake of medication is also asked.

After a physical examination, in which in particular the abdomen is examined with the special examination of the liver and gallbladder, a sample of the vomit can also provide information about the cause. A yellowish, greenish appearance suggests that it is bile. Imaging examinations, such as an ultrasound of the abdomen or a gastroscopy, then follow to rule out diseases of the gastrointestinal tract as well as the liver and gall bladder.

To exclude an intestinal obstruction, an X-ray of the abdomen is usually first taken in a left-sided position and while standing. This would show the typical “fluid level” that occurs in an intestinal obstruction. In principle, bilious vomiting can indicate various types of cancer in the digestive tract or the bile ducts.

Through various mechanisms (increased bile production, obstruction of the bile ducts, obstruction of the gastrointestinal passage), bile vomiting can occur as a result of the tumor. Typically, other symptoms such as fever, night sweats (night sweats so that clothes and bedding have to be changed) and unintentional weight loss (more than 10% of body weight within 6 months) also occur. In addition, unspecific digestive problems may occur. The following topics may also be of interest to you: Gall bladder cancer and bile duct cancer