Feeling Like Vomiting But Nothing Comes Out: 8 Causes Explained.

Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.

 

The possible causes or feeling like vomiting with nothing comes out are:

  • Gastroesophageal reflux disease (GERD).
  • Severe gastritis, Peptic ulcer disease.
  • Pregnancy.
  • Extreme pain.
  • caffeine and alcohol misuse.
  • Medications.
  • Anxiety.
  • Motion sickness.
  • Extreme workouts.
  • Migraine.
  • Labyrinthitis.
  • Some endocrinal diseases such as Addison’s syndrome.

 

1- GERD.

 

Gastroesophageal reflux disease (chronic acid reflux) is the regurgitation of stomach acid into your esophagus.

When your esophagus exposes to the injurious acid from the stomach, you will feel what is called heartburn.

One of the common causes of gastroesophageal reflux is hiatus hernia. A hiatus hernia is the protrusion of a part of your stomach from into your chest through the esophageal opening in the diaphragm.

Both causes of severe esophagitis and hiatus hernia can lead to dry heaves (feeling like vomiting but nothing comes out).

 

Symptoms of Acid reflux and GERD (ref):

 

  • Heartburn: burning feeling in your chest.
  • Nausea, vomiting.
  • Dry heaving: feeling like vomiting but nothing comes out (or regurgitation of a small amount of fluid).
  • Sometimes, trouble swallowing.
  • Cough, bad mouth odor.
  • Having a raspy voice or sore throat.

Constant or recurrent heartburn is the hallmark of acid reflux. If you experience recurrent burn with the dry heaves, you should suspect GERD.

Acid reflux is usually treated with medications that decrease gastric acidity such as Proton Pump inhibitor (as Prilosec and Nexium) and H2 blockers (such as Famotidine).

 

2- Severe gastritis or peptic ulcer disease.

 

People with chronic gastritis may also experience bouts of impending vomiting without anything coming out.

People with severe gastritis or peptic ulcer disease may start to experience vomiting at first. After that, the feeling like vomiting continues but nothing will come out.

Usually, this occurs because of incompliance to food or medications. Experiencing dry heaves is not uncommon in patients with chronic gastritis and peptic ulcer disease.

Also, in cases of acute gastroenteritis as viral gastroenteritis or food poisoning, severe vomiting can end in dry heaves with only a feeling like vomiting but nothing comes out.

The conditions of acute gastroenteritis usually present with other symptoms such as abdominal colic, diarrhea, severe nausea, and fever.

 

3- Caffeine or alcohol misuse.

 

Too much alcohol or alcohol binge drinking can lead to bad effects on your stomach. Symptoms include nausea, epigastric pain, vomiting, and dry heaves.

This is because (ref):

  • Alcohol is irritant to your stomach.
  • Too much alcohol can cause dehydration and electrolyte imbalance.
  • It affects your brain (hangover).

Also, people who drink too much caffeine (especially those who have gastritis) can experience dry heaves.

Caffeine increases the acidity of your stomach and causes severe gastric upset.

 

4- A Gallbladder attack.

 

Severe gallbladder pain attacks typically present with severe pain and vomiting. Severe attacks of nausea and feeling like vomiting but nothing comes out are also common with gallbladder pain.

 

Symptoms of a gallbladder attack include:

 

  • The onset of pain is usually related to large or fatty meals.
  • Sudden severe pain in the right upper part of your abdomen.
  • The pain may propagate into the upper middle abdomen, right side of your chest, the back, and the back of your right shoulder.
  • Usually, gallbladder pain is accompanied by severe nausea, vomiting, or dry heaving.
  • The pain lasts from minutes to hours and resolves, then recures again.

 

5- Medications.

 

Medications are one of the most common causes of gastrointestinal upset. Too many medications are capable of causing direct damage to your digestive tract or alter the vomiting center in the brain.

As a result, a single pill can lead to gastritis, nausea, vomiting, or even dry heaves.

Below, A list of medications that can potentially cause nausea, vomiting, or dry heaves:

 

Medications causing nausea or vomitingExamples
1- Analgesics: medications used to treat headache and painAspirin.Other NSAIDs such as Ibuprofen, ketoprofen.Anti-gout medications.
2- Drugs for heart diseases:Digoxin (especially over-dose).Beta-blockers (such as bisoprolol).Calcium channel blockers (as Amlodipine).Other antihypertensives and anti-arrhythmia medications.Diuretics
3- over-use of vitamin supplements (hypervitaminosis).Vitamin D overdose.Vitamin A overdose.
4- Cancer chemotherapy.Severe nausea and vomiting especially with: Cisplatinum.Dacarbazine.Nitrogen mustard. Others cause moderate to mild nausea: Methotrexate.Cytarabine.Etoposide.Fluorouracil.Tamoxifen.
5- Hormonal preparations/therapiesOral contraceptives.Anti-diabetic drugs.
6- Antibiotics / AntiviralsErythromycin.Tetracycline.SulfonamidesAnti-TB drugs.Acyclovir.
7- IBD (Crohn’s & Ulcerative Colitis) medicationsSulfasalazine.Azathioprine.
8- CNS drugs:Antiparkinsonian drugs.Anticonvulsants (& epilepsy) drugs.
9- Anti-asthma drugs:Theophylline

 

Review your recent medications. Call your doctor if your think one of the above medications caused your the feeling like vomiting without anything coming out.

 

6- Extreme pain (such as kidney colics).

 

Any case of extreme pain (either intra-abdominal or extra-abdominal) can lead to symptoms such as nausea, vomiting, and dry heaving (ref).

 

Examples of painful conditions that can induce dry heaving:

  • Kidney stones (renal colics).
  • Acute pancreatitis.
  • Biliary colic (gallbladder pain).
  • Heart attack (severe chest or upper abdominal pain).
  • Major trauma (such as bone fractures).
  • Post-surgery painful conditions.
  • Cancer pain.
  • Acute appendicitis pain.
  • Migraine headache.

 

The onset of feeling like vomiting is usually related to the onset of severe pain. Consult your doctor if you experience severe unexplained pain with dry heaving.

 

7- pregnancy.

 

Up to 70% of pregnant women feel nauseous at some point during their pregnancy (ref).

During the first 4 months of pregnancy, a severe case of vomiting with pregnancy can develop. It is called “Hyperemesis gravidarum”.

With hyperemesis gravidarum, the vomiting can be severe and develops into dry heaving (feeling like vomiting but nothing comes out.

Hyperemesis gravidarum is sought to be the sudden increase in the pregnancy hormones.

HG is more common in younger obese women, with first-time pregnancy. The condition can be severe and difficult to manage.

The symptoms of hyperemesis gravidarum usually start at the 4th or the 5th week of pregnancy. Order a pregnancy test if you think nausea and the tendency to vomit are related to possible pregnancy.

 

8- Others (less likely to cause isolated dry heaving).

 

A- Anxiety attacks.

 

Your gut and your brain are linked more than you think. The brain-gut axis is a term used to describe the strong influence of our brain on our digestive system.

Intense anxiety or extreme fear can trigger the digestive system to upset. Your digestive system responds to stress by:

  • Intense nausea, vomiting, or dry heaving.
  • Loss of appetite.
  • Diarrhea.
  • irritable bowel syndrome.
  • Functional constipation.
  • In extreme cause, eating disorders can develop such as anorexia nervosa and cyclic vomiting syndrome.

Consult your doctor if the feeling like vomiting with nothing coming out is related to extreme stress or anxiety attacks.

 

B- Motion sickness.

 

Motion sickness is a sensation of wooziness. It is triggered by motion such as traveling by car, boat, plane, or even a train.

Severe attacks of motion sickness can lead to intense nausea, vomiting, or feeling like vomiting with nothing coming out.  Other symptoms include (ref):

  • Dizziness.
  • Generally feeling unwell and tired.
  • Headache.
  • Burping.
  • Sweating.
  • Excessive saliva. 

 

C- Intense exercise.

 

Intense exercising for longer periods can lead to contractions in your diaphragm. Also, exercising directly after meals (on a full stomach) may lead to dry heaving.

If you are new to exercising and workout, always start low and make your way up gradually. Starting with high intensity can lead to dry heaving and other health problems.

Always take breaks, sip small amounts of water during the workout, and stop if you start to feel nauseous.

 

D- Migraine.

 

A migraine is a severe form of headache that causes severe throbbing pain or throbbing in the head.

A landmark of severe migraine is that it is accompanied by nausea, vomiting, or feeling like vomiting with nothing coming out.

Migraine comes in attacks. A single migraine attack can last for hours or even days. It can be severe enough to interfere with your daily work and activities.

Migraine is proceeded by a group of symptoms called the “Aura”:

  • Seeing bright spots, flashes, or various shapes. 
  • Pins and needles sensation in the arms or legs. 
  • Weakness or numbness on one side of the body or face.
  • Hearing noises or music. 
  • Difficulty speaking.

After that, the migraine attack with intense headache, sensitivity to light and sound, nausea, vomiting, or dry heaving. 

Learn more about Migraine.

 

E- Labyrinthitis or vestibular neuritis.

 

Labyrinthitis is an inflammation of the 8th cranial nerve. The 8th cranial nerve is responsible for hearing and balance. The cause of labyrinthitis is thought to be a viral infection (ref).

symptoms of labyrinthitis include:

  • Rapid onset of severe vertigo (a sensation of whirling and loss of balance).
  • Severe nausea.
  • Vomiting.
  • Dry heaving: a feeling like vomiting with nothing comes out.
  • loss of balance. 
  • Difficulty walking.
  • The above symptoms can be accompanied by unilateral hearing loss (labyrinthitis) or occur without hearing loss (Pure vestibular neuritis).

The condition is usually benign, usually resolves within days or weeks. However, the symptoms may be similar to other major diseases such as brain stem strokes or tumors.

So, any case of new-onset vertigo should be evaluated by your doctor. 

Treatment can involve some anti-vertigo medications and corticosteroids. 

 

F- Other rare causes of dry heaving.

 

  • Addison’s disease.
  • Thyroid gland hyperactivity (hyperthyroidism).
  • Renal failure (uremia).
  • Severe Diabetic ketoacidosis (DKA).
  • Radiation therapy of the upper abdomen or chest.
  • Tumors of the stomach and the esophagus.
  • Brain tumors, or strokes.