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Vomiting After Stroke: Understanding Why It Happens & How to Treat It

stroke patient in hospital bed with IV fluids being treated for cyclic vomiting

Vomiting after stroke is a worrisome condition as it depletes the body of vital fluids and nutrients. Is there a way to make it stop?

There are various causes of vomiting after stroke, and each requires its own separate treatment. This makes a correct diagnosis critical for recovery.

Work closely with your medical team to perform all necessary tests to determine the cause of persistent vomiting after stroke.

To boost your understanding, this article will discuss the causes and treatments for vomiting after stroke.

Understanding the Causes of Vomiting After Stroke

Persistent vomiting after stroke should be treated like a medical emergency. If patients lose nutrients and fluids on a consistent basis, it can rapidly deteriorate one’s health.

It can be dangerous to self-diagnose and self-treat persistent vomiting because, if the wrong treatment is pursued, it can delay recovery and worsen malnutrition. Working with your medical team is crucial.

Here are the possible causes of vomiting after stroke:

  • Cyclic vomiting syndrome. This condition is characterized by recurrent episodes of stereotyped vomiting separated by regular symptom-free periods. Researchers speculate that cyclic vomiting syndrome occurs from dysfunction between the gut-brain connection.
  • Side effects from medication. Certain medications can cause vomiting in some stroke patients. Pay attention to the timing of medication and vomiting. Check labels for side effects such as nausea and vomiting.
  • Onset of another stroke. In rare cases, vomiting could be the sign of another stroke. This is why vomiting should be considered a medical emergency! Look for other warning signs of a stroke like slurred speech and weakness in one arm or leg.
  • Damage to certain areas of the brain after stroke. Nausea and vomiting are frequently seen in patients with vertebrobasilar stroke. Also, cerebellar stroke patients commonly experience severe vertigo, nausea, and vomiting, along with poor balance.
  • Vestibular disorders. When the vestibular system is impacted by stroke, it can cause poor balance, impaired gait, dizziness, nausea, and vomiting.

Next, we’ll discuss some common treatment options that your doctor may suggest.

How Is Vomiting After Stroke Treated?

Often, hospitalization is required for persistent vomiting to replenish fluids and provide essential nutrients. During hospitalization, your medical team can perform the tests necessary to diagnose any underlying conditions.

After diagnosis, here are some treatments a doctor may suggest to treat vomiting after stroke:

Imipramine and other tricyclic antidepressant medications

doctor handing pills to stroke patient to help reduce vomiting and nausea

In one study of a stroke patient with cyclic vomiting syndrome, her vomiting finally subsided (84 days later) after taking imipramine hydrochloride. This is a tricyclic antidepressant.

Tricyclic antidepressants are thought to help vomiting after stroke due to their impact on the gut-brain axis.

The gut and brain are in constant communication with each other through this axis. If this communication has been impaired after stroke, improving this connection could help alleviate cyclic vomiting after stroke.

Adjusting Problematic Medications

If vomiting is a side effect of any new prescriptions that you’re taking, pay attention to any patterns. You may find that nausea increases after taking specific ones. If you notice any patterns, talk to your doctor. (S)he may be able to substitute the medication for something else that is more tolerable.

Vestibular Rehabilitation Training

When nausea and vomiting are accompanied by issues with balance, it could be an issue with the vestibular system. In this case, vestibular rehabilitation may help.

Vestibular rehabilitation exercises are designed to help retrain the brain and body to regulate your sense of equilibrium. In the best-case scenario, this therapy can help reduce feelings of nausea and vomiting after stroke.

Alternative Remedies: Acupuncture and Herbal Supplements

acupuncturist treating stroke patient with vomiting and nausea

Doctors may recommend using caution against alternative remedies. There is insufficient evidence that they can help, and prolonging time to effective treatment could exacerbate the negative side effects of long-term vomiting.

Still, alternative remedies could still be worth a shot, especially if they are used in conjunction with your current treatment plan.

A good first step could involve acupuncture, which has been shown to help reduce nausea and vomiting related to chemotherapy. While there don’t seem to be any studies for stroke recovery yet, acupuncture is a low-risk treatment. If you’re desperate for a solution, it could be worth a try.

Another popular natural remedy utilizes Chinese herbs for stroke recovery. While the clinical studies seem to be lacking here too, it could be worth a try if you’re interested in an alternative approach.

Overcoming Nausea and Vomiting After Stroke

With many potential causes for vomiting after stroke, it’s critical to work with a doctor for a formal diagnosis. This can help expedite treatment and reduce as much negative side effect as possible.

More research is needed in this area, but so far tricyclic antidepressants provide a hopeful treatment option. Alternative remedies can be considered in conjunction with your doctor’s approval.

We hope this article provides some of the answers you were looking for on the road to recovery.

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