Bilious vomiting: What it is, vs. nonbilious, causes, and more Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What is bilious vomiting Medically reviewed by Kelsey Trull, PA-C — By Zawn Villines on August 4, 2022Bilious vomiting means a person’s vomit is yellowish-green, which is the color of bile. The liver produces bile, a digestive fluid. Bilious vomiting may mean a person has a blockage somewhere in their gastrointestinal tract. It can also happen when a person vomits on an empty stomach. Additionally, it often happens in infants who are born with intestinal obstruction. Parents and caregivers who notice bile-colored vomit in a baby, especially in the first day or two of life, should seek emergency care. Read more to learn about bilious vomiting, its causes, risk factors, and more. What is it Share on PinterestMaria Casinos/Getty ImagesBilious vomiting means that a person’s vomit is the color of bile. This is usually green, yellow, or a mixture of the two. It often has a very bitter taste. Typically, bilious vomiting is benign, or harmless. It often happens when a person vomits on an empty stomach. However, in infants, it can be cause for concern. Bilious vomiting in infants may be a sign of a malformation in the gastrointestinal tract. Causes Bilious vomiting usually happens when something prevents bile from passing normally through the digestive tract. This typically signals some type of obstruction. One of the most common causes in newborns and young infants is duodenal atresia, a condition where the small bowel does not develop properly. This is a condition infants are born with. It causes vomiting — often bilious — within the first day or two of life. This typically happens following the first feeding. Other factors may cause bilious vomiting in both children and adults. They include: vomiting on an empty stomacha gallstone in the bile duct other congenital obstructions, such as duodenal diaphragma bowel obstructionHirschsprung disease, a congenital intestinal disorder affecting the large intestine’s ability to move stool pregnancy, especially hyperemesis gravidarum, which may cause intense vomiting that can endanger the pregnancy and pregnant person Risk factors Anyone can vomit bile. Circumstances that increase the risk include: being pregnantbeing a newborn or infanthaving a recent illness that causes intense vomitinghaving liver or gallbladder diseasehaving other congenital anomalies, such as Down syndrome Bilious vs nonbilious vomiting Vomiting is relatively common, and most people will experience it at some point. Most vomiting is nonbilious, which means vomit is not the color of bile. Some causes of nonbilious vomiting include: pregnancy infections, such as food poisoningappendicitisexposure to drugs or toxins Nonbilious vomiting is usually not green or yellow. However, it is possible for nonbilious vomiting to still look like bilious vomiting. A person’s vomit may be many different colors depending on the food they eat, how often they vomit, how much water they have had, and other factors. Diagnosis In an infant or newborn, doctors usually assume that bilious vomiting is caused by an obstruction somewhere in the intestinal tract. For this reason, they will likely treat bilious vomiting as an emergency. They will order imaging tests that may include an X-ray, or contrast imaging, which involves injecting dye into the body and then performing a scan. In adults, doctors will assess the wider context in which bilious vomiting occurs. They may: ask about recent illness or order a pregnancy test ask whether the person vomited on an empty stomachperform an exam to look for other symptoms, such as upper abdominal tendernessorder tests to look for gallstones or an obstruction Treatment Treatment depends on the likely cause of a person’s vomiting. When there is no obvious cause, a doctor may recommend waiting to see if a person improves. However, in infants, the condition will be treated as an emergency. If doctors determine the cause is a blockage such as duodenal atresia, surgery can treat the condition. Without surgery, a baby may be unable to absorb nutrients, so a doctor may recommend surgery immediately. Some other potential treatments include: antinausea drugs to stop the vomiting treatment for an underlying infectionsurgery to remove an obstruction removing the gallbladder if a person has gallstonesintravenous (IV) fluids to help a person avoid dehydration Outlook The outlook depends on the cause of the bilious vomiting. In most cases, the outlook is good with the appropriate treatment. Many people may need no treatment. For example, a person may vomit bile if they are pregnant and have morning sickness on an empty stomach or vomit on an empty stomach during a stomach virus. However, there is a risk of dehydration if a person has severe vomiting. A condition called hyperemesis gravidarum, which is a severe type of morning sickness, may cause this. In this case, a person may need antinausea medication or IV fluids. Summary Bilious vomiting can be concerning, especially if a person does not know the reason for the vomiting. However, it is treatable, and in adults, it may go away on its own. Parents and caregivers should treat bilious vomiting in newborns and very young babies as a medical emergency requiring immediate care, especially if the vomiting happens after the baby’s first meal. A doctor can determine the cause of the vomiting and treat it accordingly. Last medically reviewed on August 4, 2022Acid Reflux / GERDGastroIntestinal / GastroenterologyParenthood06 Months 7 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Andronikou, S., et al. (2018). Selective duodenography for controlled first-pass bolus distention of the duodenum in neonates and young children with bile-stained vomiting.https://www.sciencedirect.com/science/article/pii/S0009926018300096Gao, Y. C., et al. (2019). Recurrent bilious vomiting in an adult [Abstract].https://www.surgjournal.com/article/S0039-6060(19)30186-2/fulltextGotfried, J. (2022). Nausea and vomiting.https://www.merckmanuals.com/professional/gastrointestinal-disorders/symptoms-of-gastrointestinal-disorders/nausea-and-vomitingHirchsprung disease. (n.d.).https://www.niddk.nih.gov/health-information/digestive-diseases/hirschsprung-diseaseNausea and vomiting in adults. (n.d.).https://www.nidirect.gov.uk/conditions/nausea-and-vomiting-adultsSigmon, D. F., et al. (2022). Duodenal atresia and stenosis.https://www.ncbi.nlm.nih.gov/books/NBK470548Tanaja, J., et al. (2022). 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