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Introduction and Summary

Vomiting is generally thought of as an unpleasant experience, but if your body is going through the physical motions of retching without actually throwing up, you may be wishing you could vomit—if only to get some relief for your stomach and muscles. The experience of gagging without throwing up is called dry heaving, or retching. It’s often described as a feeling that you need to throw up but cannot.

Fortunately, retching is usually temporary and most people find success stopping it using at-home remedies or over-the-counter treatments.

In this article, I’ll go over the following topics:

What Is Dry Heaving?

Essentially, dry heaving or retching is the body attempting to throw up without any actual vomit.

When you dry heave, your diaphragm and abdominal walls contract, closing off your airway, expanding the lungs, and preparing your body to upheave contents from the stomach through the esophagus. You may experience gagging, feelings of nausea, and other sensations related to vomiting.

In some cases, retching can lead to actual vomiting, though in many cases the body lacks the actual substance needed to regurgitate. The brain may continue to send signals to empty the stomach, despite the stomach already being empty. In these cases, retching can become a very irritating and uncomfortable sensation that continues without the relief that’s normally felt after vomiting.

Associated Symptoms

Dry heaving can come with all of the same symptoms as vomiting, as the process of retching is technically the first stage of vomiting. These symptoms may include:

  • Gagging
  • Nausea
  • Feeling as if you need to vomit but cannot
  • Chills
  • Sweating
  • Abdominal pain
  • Indigestion
  • Regurgitating bile after unsuccessful efforts to vomit
  • Vomiting after ongoing retching

What Causes Dry Heaving?

Many people experience dry heaving immediately after bouts of vomiting as their body continues to go through the motions and contractions of throwing up. When the stomach is empty, a person may regurgitate mucus or clear fluid, or continue to gag without throwing up.

While the process of dry heaving occurs when your body wants to get rid of the contents of your stomach, there are a variety of medical reasons that may trigger it. Common causes of dry heaving include:

  • Food poisoning: Food poisoning occurs when a person ingests food allergens, toxins, or contaminated foods, triggering the body to fully empty all contents of the stomach and bowels. Vomiting is the most common symptom of food poisoning, which is often followed by periods of retching after the stomach is already empty.
  • Alcohol consumption: Drinking large amounts of alcohol in a short time can lead to gagging and retching, with or without vomiting.
  • Excessive exercise: Excessive periods of intense physical activity can cause the diaphragm to contract and trigger retching. Engaging in any kind of exercise on a full stomach can also cause retching.
  • Stress: High levels of stress, especially brought on suddenly or intensely, can cause retching. Dry heaving can be a sign of anxiety, especially for people who suffer from mental health conditions.
  • Pregnancy: Many pregnant women experience nausea to some degree during pregnancy. Dry heaving and vomiting are especially common during the first trimester, a condition that’s sometimes labeled morning sickness. Despite its name, pregnant women don’t only experience vomiting and retching in the morning—it can occur at any time of day. These symptoms tend to disappear during the second trimester.
  • GERD: Gastroesophageal reflux disease (GERD) is a disorder that causes acid reflux symptoms on a frequent basis. Along with heartburn, acid indigestion, and occasional regurgitation, GERD can cause dry heaving.
  • Indigestion: Any conditions that interrupt the digestive process, including irritable bowel syndrome (IBS) and Crohn’s disease, can lead to dry heaving.
  • Migraines: The intense pain and light sensitivity that often comes with migraines can cause nausea, vomiting, and retching.
  • Certain medications: Medications known to cause nausea and vomiting as side effects can also cause dry heaving. These medications include ones for anxiety and depression, cancer therapies, antibiotics, and insulin, among others.
  • Whooping cough: Whooping cough is an infection causes persistent bouts of coughing, which can become so severe that they lead to gagging, dry heaving, and vomiting. Childhood vaccines include vaccination against whooping cough.
  • Infections: Any severe infection in the body, regardless of where it originates, can cause the immune system to trigger a vomiting response as a reaction. A person may experience retching as the body goes through physical motions of vomiting in an attempt to combat the infection.
  • Disorders of the liver, kidney, or pancreas: Nausea and dry heaving, paired with loss of appetite, are common symptoms of diseases that impact the liver, kidney, and pancreas.
  • Cyclic vomiting syndrome (CVS): This condition causes sudden and sporadic bouts of intense vomiting and nausea, sometimes accompanied by retching. Many people with CVS also experience migraine headaches and extreme exhaustion.
  • Cannabis hyperemesis syndrome: Although it’s still not well understood, daily heavy marijuana consumption can cause cycles of abdominal pain, vomiting, and dry heaving.

Diagnosing Dry Heaving

To diagnose the cause of dry heaving, a doctor will likely start by asking you about the onset of your symptoms, your diet and lifestyle, and any medications you’re taking. In some cases, this will be enough for a doctor to identify the source and give you instructions for treating dry heaving or retching.

If you’re experiencing retching with no apparent cause, a doctor may order tests to check for underlying medical conditions. They may examine organs such as the liver, kidney, and pancreas, or look for signs of a viral infection in the body.

How to Stop Dry Heaving

No matter what’s causing dry heaves, you can usually stop or ease them with at-home treatments or over-the-counter medications. In many cases, dry heaving is temporary and isn’t dangerous, although it can feel extremely uncomfortable while it’s happening and may leave the body exhausted due to intense contraction of muscles.

If you begin retching due to consuming excessive alcohol, stop drinking alcoholic beverages and switch to drinking water or an electrolyte drink such as Gatorade or Pedialyte. If you begin retching while exercising, stop physical activity and slowly sip water.

There are a wide variety of home treatments to stop dry heaving. Because each person’s body reacts differently, not all methods work for everyone—it may help to try more than one strategy to see what your body responds best to.

You can try the following at-home remedies to stop dry heaving:

  • Drinking ginger tea or each ginger candies
  • Ingesting peppermint, as an herbal tea or mint gum
  • Eating plain carbohydrates, such as saltine crackers and plain toast
  • Holding an alcohol pad, or other source of isopropyl alcohol, about an inch away from your nose, and inhale the scent
  • Practicing relaxation techniques like deep breathing and meditation
  • Taking an antacid to help neutralize stomach acid
  • Taking an over-the-counter antiemetic (anti-nausea medicine)

Treatments for dry heaving during pregnancy

For pregnant women experiencing dry heaving, a doctor may also recommend that you try the following in addition to the at-home remedies listed above:

  • Ingesting vitamin B6 and/or B1
  • Inhaling the scent of lemon oil
  • Taking prescription anti-nausea medications
  • Acupuncture

To reduce the occurrence of retching during pregnancy, it’s important to stay hydrated and eat a balanced diet. It may help to have smaller meals more frequently throughout the day, rather than a few large meals. To reduce retching in the morning, try eating a high-protein snack before bed or a few plain crackers (like saltines) first thing after waking up.

How to Prevent Dry Heaving

If dry heaving is caused by an underlying medical condition or as a side effect of a medication, the only way to fully prevent this symptom is to treat the underlying condition and/or stop taking the medication.

In many other cases, you can prevent or greatly reduce your risk of retching by following healthy lifestyle practices related to eating, digestion, and exercise.

Here are some lifestyle tips for preventing dry heaving:

  • Remain upright after eating—lying down on a full stomach increases the risk of stomach acid flowing back up into the esophagus
  • Avoid exercising right after eating
  • Build your body’s tolerance for high intensity exercise gradually over time
  • Stay hydrated by drinking water throughout the day
  • Refrain from consuming excessive amounts of alcohol or caffeine
  • Avoid drinking alcohol on an empty stomach
  • Limit consumption of foods known to cause acid reflux

If you already feel nauseous, try the following precautions to help reduce retching:

  • Stop what you are doing and rest
  • Stay hydrated by slowly drinking water
  • Refrain from eating, or eat plain carbohydrates like saltines, toast, and plain rice
  • Drink an herbal tea with ginger, lemon, or peppermint

Risk Factors and Complications

Most of the time, dry heaving isn’t dangerous. But in rare cases when drying heaving persists frequently and without an apparent cause, it may be a sign of organ disease or a serious infection.

You may be at higher risk for experiencing dry heaving if you:

  • Recently experienced a bout of vomiting
  • Regularly consume excessive alcohol
  • Regularly exercise at very high intensity
  • Are pregnant
  • Have an anxiety disorder that causes panic attacks or similar symptoms
  • Take medication or undergo treatment known to cause retching
  • Suffer from whooping cough or another viral infection
  • Have a disorder of the liver, kidney, or pancreas

When to See a Doctor

While dry heaving alone is generally not dangerous, if it is accompanied by certain severe symptoms, it may be a sign of a serious condition that requires immediate medical treatment.

Seek emergency medical attention if you experience any of the following symptoms:

  • Severe headache
  • Vomiting blood or what appears as coffee grounds: that’s old blood
  • Vision problems
  • Fainting
  • Inability to eat or drink for over 24 hours

Speak to a doctor immediately or see a doctor in person if you experience the following symptoms, as these can indicate a more serious underlying condition:

  • Severe chest or abdominal pain
  • Dizziness or near fainting
  • Severe muscle pain or weakness
  • Increased heart rate
  • Blood in urine, stool, or vomit
  • Very little or no urination
  • Difficulty breathing

If you aren’t experiencing the serious symptoms above, but your dry heaving isn’t resolving with at-home remedies, talk to a doctor. They can help diagnose what factors may be triggering retching, and alleviate those factors if possible. They may also prescribe a stronger anti-nausea medication to help relieve your symptoms.

How K Health Can Help

Dry heaving can be very uncomfortable. Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Dr. Chesney Fowler, MD

Dr. Fowler is an emergency medicine physician and received her MD from George Washington University. She completed her residency in emergency medicine at Christiana Care Health System. In addition to her work at K Health, Dr. Fowler is a practicing emergency medicine physician in Washington, DC.