A powerful physical image illustrates the bitter downfall of a wicked person, revealing how his own evil actions ultimately become the source of his destruction [תקות אנוש, ביאור שטיינזלץ]. On a physical level, there is a complete breakdown of natural bodily systems. The very food the wicked person eats undergoes a sudden, extreme change inside him. Rather than digesting normally, his system becomes so weak that even healthy, wholesome meals transform into a deadly poison within his body [מלבי״ם]. This unnatural process makes the food unbearable in his stomach, forcing him to violently expel it [מצודת דוד]. This internal poison is compared to the toxic venom or gall of snakes [מצודת ציון, ביאור שטיינזלץ].
Beyond the physical reaction, this vivid image serves as a metaphor for the person's corrupt behavior. The food represents the evil he eagerly consumed and carried out. When disaster strikes, that same evil turns into a destructive force inside him [רש״י, ביאור שטיינזלץ]. The sharp, stinging nature of the snake venom represents the painful, bitter end that his actions naturally bring about [תקות אנוש].
This physical sickness also reflects a deep spiritual and psychological crisis. The sins the person absorbed into his life become a tormenting poison, filling him with intense regret and inner distress [אלשיך]. In a broader sense, this unnatural disruption in his gut represents how the wicked person is destined to fail in all his efforts, completely going against the normal, natural order of life [מצודת דוד].