Dry heaving is retching or going through the motions and sensation of vomiting without producing any vomit. Sucking on ice, eating a small amount of food, and resting with the head propped up are some ways to relieve it.
Dry heaves are extremely common and often occur after periods of vomiting. They can also occur alone as a symptom or side effect of an underlying medical condition or as the result of certain situations and medications.
Dry heaving is also considered the first stage of vomiting, though it does not always lead to vomiting.
Although it can be unpleasant, most cases of dry heaving only last for a short time and resolve with basic care.
For cases caused by excessive alcohol consumption, a person should immediately stop drinking alcohol and switch to clear fluids.
Moderate to severe cases of nausea and dry heaving, however, can cause serious dehydration and potentially damage the tissues and organs.
The most common medical treatment options for severe dry heaving are intravenous fluid (IV) fluids and anti-nausea medications (antiemetics).
If dry heaving is related to a specific condition, the underlying cause will also require specific treatment.
Common home remedies for mild to moderate cases of dry heaving include:
- Hydration. Taking very small, slow, sips of plain water can help a person rehydrate. It is often easier to start with ice chips or popsicles.
- Electrolytes. When the vomiting slows, a person should drink beverages rich in crucial hydration salts called electrolytes. These include many sports drinks and soup broths. Oral rehydration salt preparations can also be purchased premixed or prepared at home. Always start with small sips and increase the amount as tolerated.
- Relax and rest. If possible, a person can lie down with their head elevated and breathe deeply. Relaxing breaths can help minimize the symptoms of dry heaving.
- Food as tolerated. Once the vomiting has stopped, resume eating what appeals to you. Some find that plain foods such as porridge, toast, applesauce, broth, and bananas are easier to digest and reduce nausea. The key is to keep portions small.
- Ginger. Ginger supplements, chews, gums, and drinks have long been used to reduce nausea. Ginger is now an ingredient in some brand name anti-nausea medications, such as Gravol Ginger Tablets.
- Isopropyl alcohol. A 2015 study found that smelling a packaged alcohol pad from 2.5 centimeters away for up to 4 minutes may help reduce nausea.
- Plain carbohydrates. Saltines, dry toast, plain rice, and oatmeal are often relatively easy to digest.
- Antiemetics. Over-the-counter anti-nausea medications block the neurotransmitters that trigger nausea, dry heaving, and vomiting. Follow package instructions for use.
- Antacids. Over-the-counter antacids contain compounds, such as calcium carbonate, magnesium, and baking soda, that help neutralize stomach acids.
- Aromatherapy. One small study has shown that inhalation of essential oils with ginger or a combination of ginger, spearmint, peppermint, and cardamom may lessen nausea after surgery.
It is essential to treat or resolve cases of dry heaving during pregnancy
to avoid dehydration, malnutrition, weight loss, and potential harm to the woman and baby.
The first line of treatment for dry heaving with pregnancy is typically hydration, eating a more balanced diet, and taking supplements.
Lifestyle changes, such as eating smaller meals spread evenly throughout the day may also help reduce symptoms.
Eating a high-protein snack before bed, or a few dry saltines first thing in the morning may reduce nausea and dry heaving during pregnancy.
For more severe cases, a doctor may also prescribe anti-nausea medications and vitamins. These can include:
- pyridoxine(vitamin B6)
- thiamine(vitamin B1)
- dopamine or serotonin blockers
Though less supported by scientific study, several natural treatment options have been proposed and occasionally used to treat nausea, especially during pregnancy.
Alternative therapeutic options for nausea include:
- acustimulation, which uses mild electrical currents
- acupressure or acupressure bracelets
Dry heaving generally serves to prepare the body for vomiting by helping reverse the movement of contents in the stomach and food pipe (esophagus).
Dry heaving may also occur when the brain continues to send the signal to clear the stomach even though it is already empty.
Dry heaving involves the contraction of the abdominal walls and diaphragm, which allows the lungs to expand while the stomach and esophagus relax. This forces the contents of the stomach and esophagus upward.
When there is nothing left in the stomach to throw up, the body may continue to undergo the physical motions of vomiting but cannot expel anything except occasional mucous or clear fluid. This is dry heaving.
In some cases, dry heaving can also be triggered when there is no actual reason to empty the stomach, such as in response to a smell or a sight.
Dry heaving is often caused by a combination of factors. Vomiting and nausea often accompany dry heaving, so they share many of the same risk factors.
But there are medical conditions, medications, and certain situations that can specifically increase the risk of dry heaving.
Common situations associated with dry heaving include:
- excessive alcohol consumption
- low blood sugar
- intense exercise, especially after skipping a warm-up period or attempting exercise well beyond one’s normal level
- anxiety and stress
- motion sickness
Other conditions known to cause dry heaving include:
Pregnancy commonly causes nausea, vomiting, and may lead to dry heaving. Nausea is typically most severe during the early stages of pregnancy and is especially common early in the morning when the stomach is empty, but it can occur anytime throughout the day.
Researchers are not exactly sure why pregnancy causes nausea, but it is likely due to a combination of immune, hormone, and anatomical changes.
Conditions that interfere with digestion, such as irritable bowel syndrome (IBS), gastritis, Crohn’s disease, and gastroesophageal reflux disease (GERD) are common causes of nausea and dry heaving.
Dry heaving may be especially common during flare-ups when symptoms are more severe.
Indigestion can cause stomach acids to travel back up the food pipe, which may be uncomfortable or painful. This sensation can also cause nausea.
Regardless of the location in the body, severe infection may cause the immune system to initiate nausea and vomiting in response to the problem.
The physical presence of parasites tends to cause the intestines and stomach to feel either very full or very empty, triggering unnecessary retching.
Food allergies or poisoning
Food allergens or toxins can cause intense, sudden vomiting and a complete emptying of the stomach contents and bowels.
This severe response often continues for some time after the allergen has been cleared from the stomach, resulting in dry heaving.
Liver, kidney, or pancreas disorders
Nausea and a loss of appetite are some of the most common early warning signs of chronic disease and liver, kidney, and pancreas disorders.
Migraine headaches are a well-known cause of nausea, vomiting, and dry heaving. This is often in response to severe pain, disorientation, and light-sensitivity.
Cyclic vomiting syndrome
The condition is characterized by seemingly random, sudden spells of intense vomiting, nausea, and physical exhaustion that occur every few weeks to months.
Some medications known to cause dry heaving include:
- antidepressant medications
- anti-anxiety medications
- cancer medications and therapies
- anesthetic medications used during surgery
- insulin and metformin
Inner ear conditions
Infection, inflammation, or pain in the inner ear can cause vertigo, motion sickness, and nausea.
Severe pain or shock
The body may respond to severe pain or shock by causing nausea and often dry heaving.
Any injury or brain condition, such as trauma, bleeding, a tumor, or viral infection, can increase pressure in the brain and cause nausea and dry heaving.
If dry heaving continues for more than a 24 hours or is severe, a person should seek medical attention.
Moderate to severe cases of dry heaving can cause dehydration, which may require medical care and monitoring to prevent complications including kidney injury.
Reasons to seek immediate medical attention for dry heaving include:
- very high fever
- blood in vomit or mucous
- severe abdominal pain
- stiff neck
- unusual headache
- rapid pulse that continues even when not actively vomiting or dry heaving
- suspected head injury or infection
- presence of additional medical conditions, especially gastrointestinal conditions
- symptoms of significant dehydration, such as extreme thirst, dark-colored urine, and dry mouth
- confusion and disorientation
- loss of consciousness
While rare, persistent nausea and dry heaving may be a sign of more serious health conditions, such as an organ disease or infection. Anyone who frequently experiences dry heaving with no apparent cause should speak to a doctor.