I have vomiting episodes that lead to systemic inflammatory response syndrome without sepsis. what causes sirs? insufficient cortisol from adrenals?

Multifactorial: As a general rule, inflammatory conditions which produce the criteria necessary to term a condition sirs are induced by cytokine release, but there are many other possibilities. Generally not adrenal insufficiency. You seem to be trying to acquire a shorthand medical education. It is not that simple.

Other way around: More likely, you had sirs that caused your vomiting. Sirs is a constellation of signs and symptoms that include fever, fast heart rate, and other abnormal lab tests. A number of things can cause sirs, including infection, trauma, inflammation of the pancreas, etc. Usually, there is no connection between sirs and insufficient cortisol. Many times, they are connected, but not caused by sirs.

Pancreatitis: It sounds that you might be having recurrent pancreatitis or a gallbladder related issue.