Jeffrey Salazar
Vomiting blood, or hematemesis, is a medical emergency and requires immediate medical attention. It is the forceful ejection of stomach contents mixed with blood or blood only. The underlying cause of vomiting blood varies from minor causes such as swallowing blood from a mouth injury or a nosebleed to more serious conditions such as cancer. The treatment for vomiting blood depends on the underlying cause, and it is important to consult a doctor to determine the severity and source of the bleeding. While waiting for medical attention, it is recommended to stay hydrated by drinking clear fluids and adjusting your diet to include bland foods that are easy on the stomach, such as crackers, toast, and plain yogurt.
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What You'll Learn
Seek medical attention
Vomiting blood is a medical emergency and you should always seek immediate medical attention if you notice blood in your vomit. It can be challenging to determine the cause and severity of the bleeding without a medical opinion. Blood in the vomit is never normal, and while a small amount may indicate a benign cause, such as a nosebleed or oral surgery, it could also be a sign of something more serious.
If you are vomiting blood, you should call your healthcare provider or seek emergency medical care. Do not drive yourself to the hospital; ask someone to drive you or call an ambulance. Bring any medications you are currently taking with you. Your healthcare team will assess your condition and provide immediate support, such as IV fluids, blood transfusions, or oxygen if necessary.
To diagnose the cause of the bleeding, your doctor will ask about your symptoms, whether you have any injuries, and your medical history, including any medications you are taking. They may perform an upper endoscopy to examine your upper gastrointestinal (GI) tract, which includes the mouth, throat, oesophagus, stomach, and duodenum (the first part of the small intestine). This procedure involves passing a small, flexible tube with a camera (called an endoscope) down your throat to visualize the area and locate the source of the bleeding.
During the endoscopy, your doctor may use medical tools to seal any wounds or stop the bleeding. They may also order blood tests to check your complete blood count and assess the amount of blood lost. If they suspect that the bleeding is due to an underlying condition, such as cancer, they may order additional imaging tests to look for ruptured organs or atypical growths. It is important to follow your doctor's instructions and seek prompt medical attention to ensure proper diagnosis and treatment.
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Avoid foods that aggravate vomiting blood
Vomiting blood is a medical emergency and you should always contact a medical professional if you notice blood in your vomit. It can be challenging to determine the cause and severity of the bleeding without a medical opinion. Bright red blood indicates an acute bleeding episode in your oesophagus or stomach, while darker-coloured blood means it has been in your gastrointestinal tract for a few hours.
If you are vomiting blood, it is important to avoid foods that can aggravate the condition. Avoid spicy and acidic foods, as well as alcohol and carbonated beverages, as these can irritate the stomach and oesophagus. It is also important to stay away from foods that are difficult to digest, such as fatty and fried foods. These can increase stomach acid production and slow down digestion, making it harder for the wound to heal.
In addition, it is recommended to refrain from taking aspirin, anti-inflammatory painkillers such as ibuprofen, and anticoagulant medications (blood thinners) unless prescribed by your doctor. These medications can interfere with blood clotting and make it harder for the bleeding to stop.
It is also generally advisable to avoid foods that are hard, crunchy, or sharp-edged, as they can scrape the wound and cause further irritation. Soft, bland, and easily digestible foods are generally recommended until the bleeding has stopped. This includes foods such as bananas, rice, applesauce, and toast, often referred to as the BRAT diet.
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Identify the root cause of vomiting blood
Vomiting blood, or haematemesis, is a very serious symptom that requires urgent medical attention. It is often a sign of bleeding in the upper gastrointestinal (GI) tract, which includes the oesophagus, stomach, and duodenum (the first part of the small intestine). While there are various potential causes of vomiting blood, identifying the root cause is crucial to determine the appropriate treatment. Here are some possible root causes:
Bleeding Ulcers
Peptic ulcers, or open sores in the stomach or duodenum, can lead to vomiting blood. These ulcers are often caused by bacterial infections, regular use of non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen, or heavy alcohol consumption.
Acute Inflammation
Inflammation of the oesophagus or stomach lining can cause bleeding from the underlying arteries. This can be triggered by heavy alcohol use, certain medications like aspirin and NSAIDs, or severe acid reflux.
Enlarged or Ruptured Blood Vessels
Portal hypertension, a complication of cirrhosis, can lead to increased pressure in the abdominal veins, causing them to rupture and bleed. Additionally, conditions like chronic pancreatitis can damage the blood vessels around the pancreas, resulting in bleeding that can extend to the duodenum.
Tumours
Both benign and malignant tumours in the stomach, oesophagus, or pancreas can cause bleeding. It is crucial to undergo testing to determine the nature of the tumour and rule out cancer.
Angiodysplasias
These are abnormal surface blood vessels that can lead to bleeding in the stomach and intestines.
Mallory-Weiss Syndrome
This condition involves a tear in the oesophagus, typically resulting from violent vomiting or excessive alcohol consumption.
Medications and Substances
Certain medications and substances can increase the risk of vomiting blood. These include aspirin, anti-inflammatory painkillers like ibuprofen, anticoagulant or blood-thinning medications, and excessive alcohol use.
It is important to note that this list is not exhaustive, and there may be other, less common causes of vomiting blood. If you or someone you know is experiencing this symptom, it is crucial to seek immediate medical attention. A healthcare provider will perform a thorough evaluation, including an upper endoscopy exam, to determine the root cause and provide appropriate treatment.
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Understand the severity of bleeding
The colour of vomited blood may indicate the source and severity of the bleeding. Bright red blood is fresh and indicates an active bleed, which might be heavier and more urgent. Coffee ground vomit — blood that looks brown and lumpy — is older blood. It may indicate a slower bleed or one that has stopped. It usually takes a significant amount of bleeding to trigger vomiting.
If you are vomiting a lot of blood, you are at risk of going into hypovolemic shock, which can cause organ failure and even death. This is a rare event, but it is a medical emergency and you should seek treatment right away. If you experience any symptoms of shock, have someone drive you to the ER or call an ambulance.
If you are showing signs of severe blood loss, your healthcare team will treat this first with IV fluids, blood transfusions and oxygen support if necessary. These steps are referred to as resuscitation. After resuscitation, your healthcare team will need to investigate the cause of your condition. They will ask you when you started vomiting blood, what it looked like, and whether it has happened before. They will also obtain a detailed history of your medication use, including aspirin, NSAIDs, and blood thinners.
To locate the source of the bleeding and make sure it has stopped, your healthcare team will need to look inside your upper GI tract. The most efficient way to do this is with an upper endoscopy exam. An endoscopy allows healthcare providers to see inside your GI tract and stop the bleeding. During the exam, you will be given medicine to relax and sedate you.
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Know when to go to the ER
Vomiting blood is a medical emergency and should be treated as such. It is important to call your healthcare provider if you are vomiting blood. While vomiting itself is unlikely to cause death, severe blood loss can. If you are bleeding a lot, you are at risk of going into hypovolemic shock, which can cause organ failure and death.
If you have vomited a lot of blood, you may need emergency treatment. Call 911 or go to the emergency room (ER) immediately. Do not drive to the ER. Ask someone to drive you or call an ambulance. Bring any medicines you take with you.
The color of vomited blood may help indicate the source and severity of the bleeding. Bright red blood often indicates an acute bleeding episode in your esophagus or stomach and may represent a fast-bleeding source. Darker-colored blood means the blood has been in your gastrointestinal tract for a few hours and usually represents a slower and steadier source of bleeding. Coffee ground vomit—blood that looks brown and lumpy—is older blood and may indicate a slower bleed or one that has stopped.
To diagnose the cause of blood in your vomit, your doctor will ask about your symptoms and whether you were recently injured. They will also obtain a detailed history of your medication use, including aspirin, anti-inflammatory painkillers such as ibuprofen, NSAIDs, and blood thinners. An upper endoscopy exam will allow healthcare providers to see inside your gastrointestinal tract and stop any bleeding. During the exam, you will be sedated, and your healthcare provider will pass an endoscope (a lighted camera on a thin tube) down your throat and into your duodenum.
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