What are the most dangerous vs. most common causes of vomiting in different age groups, including newborns (0-1 month), infants (1-12 months), young children (1-5 years), and teenagers (13-19 years)?

From the Guidelines

Vomiting causes vary significantly across age groups, with some being more common and others more dangerous, and it is crucial to identify the most dangerous and common causes in each age group to provide appropriate care and prevent morbidity and mortality. In newborns (0-1 month), the most dangerous causes include pyloric stenosis (requiring surgical intervention), intestinal malrotation with volvulus (a surgical emergency), and metabolic disorders, while common causes are gastroesophageal reflux, overfeeding, and improper feeding techniques 1. For infants (1-12 months), dangerous causes include intussusception (bowel telescoping), meningitis, and urinary tract infections, with common causes being viral gastroenteritis, food allergies, and continued reflux issues 1. Young children (1-5 years) face dangerous vomiting from appendicitis, diabetic ketoacidosis, and toxic ingestions, while commonly experiencing gastroenteritis, food poisoning, and motion sickness 1. Teenagers (13-19 years) should be concerned about appendicitis, pancreatitis, and pregnancy complications as dangerous causes, with common triggers including gastroenteritis, migraines, and stress-related vomiting 1. Some key points to consider in the management of vomiting in different age groups include:

• Maintaining hydration with small, frequent sips of oral rehydration solutions like Pedialyte for younger children or diluted sports drinks for teenagers, while avoiding solid foods until vomiting subsides 1
• Seeking immediate medical care for projectile vomiting, bile-colored vomit, blood in vomit, severe abdominal pain, or signs of dehydration such as decreased urination or excessive drowsiness 1
• Considering simple cheap interventions, such as minor feed modifications or thickening agents, when possible and avoiding acid suppressing drugs in isolated overt regurgitation 1
• Evaluating for dehydration, which increases the risk of life-threatening illness and death, especially among the young and older adults 1
• Using reduced osmolarity oral rehydration solution (ORS) as the first-line therapy for mild to moderate dehydration in infants, children, and adults with acute diarrhea from any cause 1 It is essential to prioritize the most recent and highest quality study, which in this case is 1, to guide clinical decision-making and ensure the best possible outcomes for patients.

From the Research

Newborns (0-1 month)

• Most common causes of vomiting:
  • Gastroesophageal reflux disease (GERD)
  • Infectious gastroenteritis
  • Pyloric stenosis
• Most dangerous causes of vomiting:
  • Intestinal obstruction
  • Volvulus
  • Necrotizing enterocolitis 2

Infants (1-12 months)

• Most common causes of vomiting:
  • Acute gastroenteritis
  • GERD
  • Food allergies or intolerances
• Most dangerous causes of vomiting:
  • Intussusception
  • Pyloric stenosis
  • Bacterial meningitis 2, 3

Young Children (1-5 years)

• Most common causes of vomiting:
  • Acute gastroenteritis
  • Viral infections
  • Food poisoning
• Most dangerous causes of vomiting:
  • Intestinal obstruction
  • Appendicitis
  • Bacterial gastroenteritis 4, 2

Teenagers (13-19 years)

• Most common causes of vomiting:
  • Viral gastroenteritis
  • Food poisoning
  • Pregnancy-related morning sickness
• Most dangerous causes of vomiting:
  • Appendicitis
  • Intestinal obstruction
  • Inflammatory bowel disease 2, 5