What Does Orange Vomit or Bile Mean? Causes & Treatment

Key takeaways:

• Bright orange vomit can be concerning, but it rarely indicates something serious.
• A full clinical picture, including your medical history, dietary habits, and additional symptoms, is important in identifying the cause of orange vomit.
• If you’re unable to hold down fluids for more than 24 hours, be sure to consult your doctor.

Nausea with associated vomiting is never a pleasant experience. But did you know that the color of your vomit could give your healthcare provider important clues about your health? Although vomiting is often caused by minor issues, pay attention to the color. If you see that your vomit is orange, consult with your doctor to make sure it’s not a sign of something more serious.

What is orange-colored vomit or bile?

First, it helps to know the difference between vomit and bile; although they are related, they’re not the same. Bile is a yellow or greenish-yellow liquid that’s produced by the liver and stored in the gallbladder. Vomit refers to the contents of your stomach that you expel by throwing up. Vomit may or may not contain bile.

When vomit or bile is orange, it could be the first sign of a viral gastrointestinal (GI) infection. The orange color is often linked to bile and stomach acids in the vomit, and may also be a sign of partially digested food. While certain colors in the vomit can signify a serious health condition, orange vomit is not typically a serious concern. However, there are a few reasons for orange-colored vomit that require medical attention.

When throwing up orange vomit or bile may be serious

One instance when throwing up orange vomit or bile can be serious is when it’s linked to aGI infection.

This may cause repeated, excessive vomiting that leads to dehydration – and that’s dangerous to your health. More than half of your body weight comes from water, and your vital organs depend on it to function. Dehydration can interfere with the proper functioning of your organs and even cause permanent damage to them.

So, if you are unable to hold down fluids for more than 24 hours, seek medical care immediately.

Common causes of orange vomit or bile

If you are throwing up orange vomit or bile, there could be several causes. Identifying additional factors associated with orange vomit can help both you and your doctor determine what is causing your symptoms.

Infection

Infections like viral gastroenteritis – more commonly referred to as the “stomach flu” – can lead to nausea or vomiting.

The same is true of food poisoning caused by eating contaminated food. In these situations, it’s normal for the vomit to appear orange at first from partially digested food or the presence of bile and stomach acids. These conditions will usually resolve on their own within a few days. While you’re recovering, though, be sure to keep sipping fluids to prevent becoming dehydrated.

Diet

Although uncommon, foods high in natural orange pigments known as carotenoids can lead to orange-colored vomit.

Also, food choices that may trigger or worsen acid reflux (such as spicy or acidic foods or drinks containing caffeine or alcohol) can lead to more bile or digestive fluids in vomit.

Malabsorption syndromes

Fat malabsorption occurs when fat isn’t digested properly. Inflammatory bowel diseases (ulcerative colitis and Crohn’s disease) and the digestive disorder known as celiac disease, all cause gastrointestinal inflammation.

This, in turn, can disrupt the digestion and absorption of fat. Collectively, these conditions can lead to abdominal pain, nausea, and diarrhea, as well as orange-colored vomit..

Liver and gallbladder disease

Underlying issues with the liver or gallbladder (such as liver failure, hepatitis, cirrhosis, or gallstones) may lead to impaired or decreased production of bile acids.

Bile acids are needed in the breakdown of fat and can lead to fat malabsorption. Additionally, impairment in the production and metabolism of bile can cause it to appear more prominently in the vomit, which may lead to orange discoloration.

Common causes of orange vomit or bile based on appearance or another symptom

Beyond color, other characteristics can help in diagnosing the underlying cause of orange vomit. It is important to discuss any symptoms or abnormalities you notice in the vomit with your healthcare provider.

Bright orange vomit or bile

As digestive acids break down food, it naturally turns orange. So, if you vomit shortly after eating, a bright orange color likely indicates the presence of partially digested food – and is rarely cause for concern.

As food moves through the GI tract, it becomes more digested and its color will start changing to what would be considered “normal.”

Orange, oily vomit or bile

Oily vomit suggests fat malabsorption due to an underlying condition. As previously mentioned, disease processes that cause fat malabsorption include ulcerative colitis, Crohn’s disease, and celiac disease.

Problems with the liver and gallbladder can also lead to fat malabsorption, and issues with bile production leading to orange, oily vomit. If you notice the presence of oil in the vomit, it is important to consult your provider for further workup.

Orange and yellow vomit or bile

Orange and yellow vomit may be a sign of bile reflux. This condition occurs when bile that’s released into the small intestine to help digest food flows back into the stomach and esophagus.

Some patients with bile reflux experience no symptoms, while others may experience nausea, abdominal pain, yellow- to orange-colored vomit, a bitter and acidic taste in the mouth, and poor appetite. If this condition is not properly addressed, it can cause painful inflammation in the stomach and esophagus. It may also lead to the development of pre-cancerous lesions.

Orange, liquid vomit or bile

The most common cause of orange, liquid vomit is vomiting on an empty stomach. If you have not recently eaten anything, your stomach contents will include bile, saliva, and other digestive fluids. This will lead to vomit that has a liquid consistency.

Vomiting orange and experiencing diarrhea

If your vomit is orange-colored and you’re also suffering from diarrhea, you likely have a GI infection or food poisoning.

Although these conditions can make you feel miserable, they are usually benign and clear up on their own. However, in cases where you experience severe and repetitive vomiting, it can lead to dehydration. If you are unable to keep down any food or fluids for more than 24 hours, see your doctor as soon as possible.

Vomiting orange on an empty stomach

In most cases, vomiting orange on an empty stomach simply means the vomit contains bile and digestive fluids.

Unless your vomiting is excessive, persists beyond 24 hours, and/or you have other associated symptoms, this is typically not a cause for concern.

Vomiting orange while pregnant

If you’re pregnant and experience orange vomit, the causes are typically the same as those seen in non-pregnant individuals.

Viral infections, food poisoning, bile reflux, and underlying fat malabsorption conditions should all be considered. If you experience excessive vomiting while pregnant, always consult your healthcare provider. Dehydration during pregnancy can harm both the mother and baby and should be addressed immediately.

Vomiting orange after drinking alcohol

It is common to vomit bile after drinking alcohol, particularly if you consume it on an empty stomach.

Alcohol use disorder can also lead to serious liver conditions like cirrhosis or alcoholic hepatitis. Any condition that impacts the liver can lead to disruptions in bile acid production and metabolism, causing more bile to appear in the vomit and discolor it.

Vomiting orange in the morning only

Many people associate morning vomiting with pregnancy-related morning sickness. However, there are other reasons for nausea and vomiting in the morning. One example is a disorder known as cyclic vomiting syndrome (CVS). It is characterized by nausea and vomiting that start at the same time of day, last the same length of time, and occur with the intensity of previous episodes. Although this can occur at any time of day, cyclic vomiting syndrome most commonly begins in the morning.

Similarly, gastroesophageal reflux disease (GERD), better known as acid reflux, may also cause nausea and vomiting in the morning. With both cyclic vomiting syndrome and GERD, if you vomit before eating in the morning, the contents of the vomit will primarily be bile. This will cause it to be yellow to orange in appearance.

Read our guides on different types of vomit and its colors for more.

Diagnosing the causes of orange vomit or bile

As with most types of health conditions, diagnosing the cause of orange vomit relies heavily on your clinical picture and history. You’ll have a thorough physical exam. Your healthcare team will ask you questions about your medical history, diet, surgical history, and family history. They will also ask about any alcohol consumption or history of smoking, as well as about any additional symptoms to help them determine a diagnosis.

Additional testing such as bloodwork, imaging studies, and endoscopy may be ordered. This is especially true if your doctor suspects your orange vomit is related to a problem with your gallbladder, liver, or a condition causing malabsorption within the GI tract.

Common treatment options for orange vomit or bile

By now, it should be clear that orange-colored vomit is seldom a reason for major concern. Treatment options to manage orange vomit are fairly simple and can be easily addressed by your healthcare team.

Medication

Depending on the identified cause of your orange vomit, your doctor may prescribe medication to treat the symptoms.

If your orange vomit is determined to be from an infection (like viral gastroenteritis or food poisoning), you may start taking anti-nausea medication to stop the vomiting. Acid-reducing medications can also be helpful, especially in situations where acid reflux is causing your orange vomit. More specific medications could be prescribed if you’re diagnosed with an underlying fat malabsorption condition.

Hydration

Maintaining hydration when you’re vomiting is arguably the most important step in the management process – even though it can be difficult.

If you can tolerate it, your doctor may recommend oral rehydration with water and liquids that contain sugar and electrolytes. If you’re unable to keep any liquids down, you will receive IV fluids.

Lifestyle changes

Lifestyle changes may be necessary, depending on the identified cause of your orange vomit. Celiac disease, acid reflux, Crohn's disease, and ulcerative colitis all come with individualized dietary recommendations.

Smoking and alcohol consumption are predisposing factors for many of the causes of orange vomit discussed throughout this article. If applicable, your doctor will discuss ways to cut back on alcohol consumption and quit smoking.

Questions to ask your doctor about orange vomit or bile

• What could be causing my orange vomit?
• Does orange vomit signify a more serious health condition?
• What kind of workup will I have to diagnose the cause of my orange vomit?
• What management options can I use to address my orange vomit?

Frequently asked questions: orange vomit or bile

Here are answers to some of the most common questions patients ask about orange vomit.

What can you eat or drink after throwing up orange vomit or bile?

If you are experiencing episodes of vomiting, your doctor will likely recommend clear liquids.

When you can tolerate solid foods, you'll be advised to start with bland solids. In many cases of orange vomit, there won’t be any specific dietary recommendations beyond that. In cases where you’re diagnosed with acid reflux or a malabsorption disorder, you’ll receive more specific dietary guidelines.

Read our guide on what to eat or drink after vomiting for more.

Is orange vomit a sign of food poisoning?

Orange vomit can be a sign of food poisoning. Food poisoning will typically cause nausea and vomiting shortly after eating contaminated food. It is common for partially digested food to appear orange in the vomit.

Be proactive, but don’t panic

Noticing that your vomit is orange might be alarming at first – , but it isn’t necessarily concerning. You should always consult your healthcare provider if you are experiencing orange-colored vomit, especially if you have additional symptoms or are unable to tolerate any fluids by mouth. However, in most cases, the cause will be something that can be treated easily in an outpatient setting.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

Sources

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Hosseini, Nooshin et al., “Alcoholic Hepatitis: A Review,” Alcohol and Alcoholism (Oxford, Oxfordshire) vol. 54,4 (2019): 408-416. doi:10.1093/alcalc/agz036. https://pubmed.ncbi.nlm.nih.gov/31219169.

Marcin, Ashley. “Vomit Color Chart: What Does It Mean?” Healthline, 5 May 2022, www.healthline.com/health/green-vomit#orange-vomit. Accessed 11 Oct. 2024.

Shi, Xiaolan et al. “Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management,” Gastroenterology Research and Practice, vol. 2022 2642551, September 12, 2022. www.ncbi.nlm.nih.gov/pmc/articles/PMC9484982.

Zuvarox, Tyesha. and Chris Belletieri. “Malabsorption Syndromes.” StatPearls, StatPearls Publishing, July 24, 2023. https://pubmed.ncbi.nlm.nih.gov/31971746.