- (slang, idiomatic) To confess, or to divulge secrets, typically speaking freely and at length after a change of motive or an incentive.
- At first, the suspect would not tell us anything about the other participants in the crime. But after being offered a deal, he spilled his guts.
- (slang, idiomatic) To vomit.
As with all reflexive forms, this may be used with any pronoun, as I spilled my guts, he spilled his guts, they spilled their guts etc.