Dry Heaving

Dry heaving is when your body goes through the motions of vomiting, but nothing comes out. Also known as retching, it’s the second phase of the full process of vomiting.

Vomiting is a three-phase process:

1. Nausea
2. Dry heaving
3. Vomiting

But you can have dry heaves without actually vomiting. That could be because you managed to control the urge to vomit, whatever made you want to vomit resolved or because your stomach is empty.

You can also vomit without having nausea or dry heaves. But skipping those phases is less common.

How dry heaving works

When you vomit, muscles in and around your upper digestive tract flex and squeeze. That pushes what’s in your stomach up your esophagus, through your throat and mouth and out of your body.

Dry heaving involves the same set of movements as vomiting. And while you might not throw up, dry heaving still has an important role. It mixes your stomach’s contents, and it starts moving them back and forth into and out of your esophagus. The mixing and movement both make vomiting easier.

What are the most common causes of dry heaving?

Dry heaving happens for all the same reasons as vomiting. Examples include:

• Alcohol use and hangovers
• Cyclic vomiting syndrome
• Dehydration and electrolyte imbalances
• Digestive tract infections and inflammation, like stomach flu, gastroenteritis or food poisoning
• Digestive tract blockages and conditions, like gastroparesis
• Extreme pain
• Gastroesophageal reflux disease (GERD) and other causes of indigestion
• Intense physical activity
• Medicines, like chemotherapy drugs, or opioids, like morphine
• Migraines
• Motion sickness and vertigo
• Poisoning, like carbon monoxide poisoning or salicylate toxicity
• Pregnancy and related conditions, like hyperemesis gravidarum
• Stress or strong emotions, like anxiety or disgust
• When something triggers your gag reflex

How is dry heaving treated?

Dry heaving typically doesn’t need treatment. But when it does, the treatments are the same as for nausea and vomiting. That usually involves changes to what you eat and drink.

If necessary, a healthcare provider may also recommend antiemetic drugs, which lessen nausea so you don’t vomit. Some of these are available over the counter. They’re generally safe when you take them as instructed on the label. But they can still interact with other medicines you take or health conditions you have. The safest move is to check with your healthcare provider about what antiemetic drugs you should or shouldn’t take.

The reasons why dry heaving may need treatment are also the same as for nausea or vomiting. Examples include:

• Preventing complications, like Mallory Weiss tears or esophageal ruptures
• If you have or could develop dehydration or electrolyte imbalances
• When it happens with serious chronic conditions, like gastroparesis

Mental health treatments

Mental health treatments can help with nausea, dry heaving and vomiting that stem from anxiety or stress. Some of the potential treatments include:

• Talk therapy methods, such as cognitive behavioral therapy
• Exposure therapy
• Anxiety medicines

Can dry heaving be prevented?

Sometimes. The main way to prevent dry heaving is to prevent nausea or vomiting. That usually includes:

• Avoiding triggers, like certain foods and smells
• Preventing motion sickness
• Good handwashing habits
• Using proper food safety techniques (like avoiding cross-contamination and cooking foods at the right temperatures)
• Preventing poisoning from carbon monoxide, medicines or chemicals