The Complete Guide to Throwing Up Underwater

By Jesse Iacono & Samantha Madigan

The scuba struggle is real!  Involuntary functions of the body are going to follow us underwater whether we like it or not.  Until we can find a way to tuck them away in a dry bag with our phones and wallets back on shore, they will remain our uninvited dive buddies.  The degree of intrusiveness can vary from function to function, so let’s start at the top with the baddest buddy around.  Here is everything that you need to know about dealing with Mr. Vomit during your dive.


Vomit is usually comprised of partially digested and undigested food and beverages that were recently consumed, saliva, stomach acid, bile from the small intestine, digestive enzymes, mucus, and water.  Typically, throwing up is a function of the body that serves the purpose of ridding the stomach of any irritants
or harmful substances before they can be digested and absorbed into the body.  Lucky for us, there are various other triggers that can induce the deed as well.  The reasons for throwing up underwater are often the same as, but not limited to, those in the terrestrial world.  A diver’s puke trigger could stem from an upset stomach, empty stomach, food intolerance, overeating, food poisoning, seasickness, being hung over, migraines, medications, presence of surge, breathing in saltwater, vertigo, lack of sleep, lack of water, other injuries or ailments, emotional stress, a reaction to certain odors, or many other reasons.  (PHAA)


There are very many types of puke; some dive operations will even give out awards for the best characteristics (color, consistency, amount, etc.) for those who get sick at the surface.  At the end of the day, they all gurgle down to two major categories; chunky and smooth – just like peanut butter, but way grosser!

Smooth vomit will likely result from an empty stomach, ingesting foods with a soft or liquid consistency, or allowing oneself ample time to digest the food before diving.  Smooth vomit is much more of a delight to encounter underwater as it will easily flow through the regulator and out the exhaust valve.  Although it may coat the inside of your regulator, it is unlikely that any clogging or change in performance will result.

Chunky vomit often results from poorly chewed food and/or a recently ingested meal.  If the body has not had the time it needs to properly digest the food, then the chunky contents of ones stomach will be sure to rear their ugly heads.  With chunky vomit, the diver will face more of a challenge when expelling underwater.  This consistency will be more likely to have trouble making its way through the regulator or lodge itself within the regulator.  Cleanup may be more involved and inspection both under and above the water may be necessary to ensure proper functionality and avoid eating part of your meal a second time.


Throwing up underwater may pose some benefits to the diver.  Most importantly, it may alleviate the symptoms that diver has been experiencing.  Sometimes
all it takes is a boot and rally to feel better again and continue on your way.  It also can put on quite the show for the diver and their buddy.  If there are
any resident fish in the area, they will likely flock in to feast on the past meal that one has so generously decided to share with them.  This can be quite the spectacle and offer for a sweet photo opportunity if your buddy has a camera and a quick trigger finger.

As wonderful as it sounds, puking underwater isn’t all fun and games; there are several concerns a diver should keep in mind if they encounter the situation.  Throwing up can be a strenuous process and takes its toll on our bodies.  The act itself can be incapacitating and particularly dangerous if your regulator is lost in the process.  Excess debris can also clog and compromise your regulator.  The loss of fluids can contribute to dehydration, the movement of vomit through the esophagus temporarily closes the airway, and the rapid expulsion of air and vomit can cause quite a strain on the stomach, ears, and top/back of the head.  Nausea and vomiting can also be indicators of a more serious issue, especially if encountered without warning, so they should not be taken lightly.


When the urgency strikes you, you’d better not lose your nerve.  When it’s vom time, maximize your success with the following steps:

Stop and Stabilize.
Keep in mind that while throwing up may not seem like the most difficult task, it can expose you to other types of risk.  Anyone who has thrown up before knows that during the act, one is in a vulnerable and crippled position.  When you are throwing up, your awareness is essentially limited to just that.  While there may be some upchuck ninjas out there who can continue to swim, maintain their position in the water column, and hurl simultaneously, the rest of us may need to slow it down a bit.  The concern here is twofold; during the process of throwing up, one is at risk of losing control of their buoyancy and one’s airway is momentarily closed.  For this reason, it is recommended that a diver avoids ascending in any way while throwing up.  If time permits, stop yourself and your buddy and stabilize your position in the water column.  Stabilization can be accomplished through buddy vigilance, negative buoyancy, or the use of a stationary object such as a rock, structure, or line.  This will allow your focus to be on the task at hand, have your buddy nearby to watch your back, and avoid losing control in the water.

Secure the Second Stage.
In almost every open water class, the question of whether or not to remove the regulator comes up.  The mentality behind this question certainly makes sense when thinking in terrestrial terms, but one must consider the implications when underwater.  Immediately after vomiting, your first reflex is to gasp in a large breath of air.  If your regulator is out of your mouth, it is unlikely you will be able to replace it before the gasp.  Lungs don’t handle water very well, so one can connect the dots here.  Make sure to keep a hand on the regulator second stage to maintain control and secure it in place.  This ensures that the regulator is not accidentally spat out during the process and gives easy access to the purge button in the case that you need a little help ridding the chamber of any breakfast nostalgia.

Throw Up Through the Regulator.
As with many of our most flattering oral-based processes (burping, coughing, hocking a loogie, etc.), throwing up can be successfully accomplished through one’s regulator.  Because of the way a regulator is designed, anything that comes out of our mouth will enter the chamber through the mouthpiece and exit through the exhaust valve.  For anything that may get hung up, the purge button should do an excellent job of blasting it out through the exhaust valve, but make sure to touch your tongue to the top of your mouth as a shield and inhale cautiously just in case.  As previously mentioned, keeping the regulator in your mouth also ensures that normal breathing can be immediately reestablished once your groceries have been yodeled.

Evaluate, Clear, and Continue
After getting over the breakup with your last meal, you will want to evaluate both your equipment and physical/mental stability.  Switch to your clean, puke free secondary regulator and take a moment to swish some water around in both your mouth and primary regulator to help clear any remaining tastes, coatings, or debris.  Conduct a brief inspection of your primary to ensure that no vomit remains inside and all accessible parts are functioning properly.  If you are unable to verify that the primary regulator is performing properly, or if you refuse to use the pukey reg, ending the dive is recommended as one of your second stages has been compromised.  If proper functionality is confirmed, some may choose to replace their primary, but others prefer to finish the dive on their secondary.  Either way, secure the extra regulator into its appropriate place and continue on.  Next, take an honest look at how you are feeling.  Throwing up can take a lot out of you and compromise mental and physical dexterity. If the sickness has not
subsided or you feel worst than before, you will want to consider ending the dive.  If you are feeling better, you may continue your dive, but proceed with caution just in case the urge strikes again.


Once out of the water, the cleaning/maintenance process will be much more involved.  If the regulator is a rental, please be courteous and try to give it a thorough rinse in fresh water before returning it.  Be sure to let the facility know that it was thrown up in so they can take the appropriate steps to clean and inspect the equipment before offering it to another customer!

If the regulator belongs to you, then the cleaning can be as involved as you would like, but the following guidelines may help.  Rinse the regulator second stage thoroughly with fresh water inside and out.  You may want to allow it to soak for some time to loosen up any remaining matter.  Be sure to swish the regulator around to dislodge any debris that may be left inside.  If you want to be extra thorough, use a cleaning solution that is approved for scuba gear and scrub all accessible parts with a finger or soft toothbrush.  If you want to freshen things up a bit, you can also spray or dip the mouthpiece in mouthwash.

Finally, if you have any remaining concern about whether the regulator is entirely cleaned and performing properly, some disassembly may be helpful.  It is important to keep one’s training in mind when performing such maintenance on a regulator as it is a piece of life support equipment.  If you are qualified to do so, removing the front casing from the second stage will expose the diaphragm and inner chamber of the regulator.  Removing the diaphragm will allow you to see inside and be certain if any debris is left behind. From here, you can clean as necessary and reassemble.  If you are not certified to do so, or question the performance of the regulator, take a quick trip to your nearest dive center to have a certified technician take a look at the regulator and determine whether any work is necessary.

A Final Word

As with many variables of scuba diving, getting sick underwater can illicit different reactions from each individual.  Always keep in mind that you know your body better than anyone else, so your response may not be the same as the next diver’s.  While some individuals can toss a quick sidewalk pizza and continue about their day without missing a beat, others are incapacitated from spilling their guts.  It is worth mentioning that if you feel anything but great underwater, it is best to call the dive instead of attempting to persevere through the physiological pressures that you are experiencing.  That being said, sometimes one does not have the luxury of ending the dive before encountering an issue.  Other times, one may feel that such an issue is simply an inconvenience and not worth ending a dive over.  Regardless of your outlook, try to keep safety in mind and food in stomach.


“Vomiting Up Water, Clear Fluid, Mucus Causes.” PHAA, n.d. Web. 12 Oct. 2016.

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