Uncontrolled Vomiting or Diarrhoea — When It Becomes an Emergency
Vomiting or diarrhoea during chemotherapy can become dangerous within hours. If you cannot keep fluids down, that is not something to wait out at home — it is a reason to call your team or go to the emergency department now.
Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed September 2026
- 24 hours is the threshold — If you have not been able to keep any fluids down for 24 hours, go to hospital. Do not wait for your next scheduled appointment.
- Dehydration sets in fast on chemotherapy — Your body's reserves are already under strain. Fluid loss becomes dangerous more quickly than it would at other times.
- Blood is never normal — Blood in vomit or stool during chemotherapy is a medical emergency. Go to the nearest emergency department immediately.
- A drip cannot wait — If you are severely dehydrated, only intravenous fluids can replace what you have lost quickly enough. Home remedies cannot substitute for hospital care.
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Vomiting or diarrhoea that stops you keeping fluids down for 24 hours is a medical emergency during chemotherapy. Go to the nearest emergency department or call your team immediately. Dehydration on chemotherapy sets in faster than usual and can become dangerous within hours — do not wait.
If a symptom below applies to you, do not wait for a callback. Call 1800-202-8726 or go to your nearest emergency department.
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Dr. C. Raghavendra Reddy
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MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Not sure whether this counts as an emergency?
Call the helpline. It is always better to check than to wait.
How do you tell manageable from an emergency?
| Sign | Manageable — call your team | Go to hospital now |
|---|---|---|
| Keeping fluids down | Can sip small amounts and keep them down | Cannot keep any fluid down |
| How long it has lasted | Under 24 hours and not getting worse | 24 hours or more, or clearly getting worse |
| Urine output | Reduced but still passing some urine | No urine for many hours, or very dark brown |
| Blood | None in vomit or stool | Any blood in vomit or stool, or black tarry stool |
| Level of alertness | Alert, able to speak and move normally | Confused, drowsy, or too weak to stand safely |
| Typically starts | Within 1–2 days of a chemotherapy cycle | Any point — seek care immediately if severe or not improving |
Signs of dehydration to check right now
- Your mouth and lips feel very dry or sticky
- You have not passed urine in many hours, or your urine is very dark
- You feel dizzy or faint when you stand up
- Your eyes look sunken or your skin feels very dry
- You feel confused, extremely weak, or your heart is beating unusually fast
- You have a fever alongside the vomiting or diarrhoea
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Frequently asked questions
I have vomited a few times but can still sip water — do I need to go in?
If you can keep small sips down and vomiting is not getting worse, call your team rather than going straight to emergency. They will ask how much you can keep down, whether there is blood, and whether you have a fever. If it has gone on for 24 hours without improvement, or if any of the red flag signs above appear, do not wait any longer — go to the emergency department. The call is to help your team assess; if they cannot reach you quickly and you are getting worse, go in without waiting for them.
Can I take extra anti-nausea medicine if the vomiting is very bad?
Call your team before taking anything extra, even if you have anti-nausea tablets at home such as ondansetron (Emeset, Zofran) or metoclopramide (Perinorm). Taking more than you were given can cause its own problems, and it may also mask the worsening your team needs to assess. If you cannot keep any fluids down at all, a tablet may not reach your system usefully — which is another reason that a drip and hospital assessment may be what is actually needed.
Can vomiting and diarrhoea happen at the same time on chemotherapy?
Yes, and when they happen together the risk of dehydration is much greater than with either alone. Some chemotherapy regimens cause both. The 24-hour threshold applies just as strongly — and losing fluid from both at once means the danger point arrives sooner. Tell your team that you have both at the same time, because that changes how urgently they will ask you to come in.
How will the hospital treat severe dehydration?
The immediate step is intravenous fluids — a drip — to replace what you have lost more quickly than drinking alone can. Your team will also check blood tests to see how your kidneys and electrolytes are, and to rule out infection, which is a separate concern on chemotherapy. Anti-nausea medicine can be given through the drip to work even when you cannot keep tablets down. Most people feel significantly better within hours of starting fluids.
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