Vomiting blood (hematemesis) is the regurgitation of stomach contents mixed with blood, or the regurgitation of blood only. Vomiting blood sounds jarring, but in some cases, it may be triggered by minor causes such as swallowing blood from a mouth injury or from a nosebleed. Vomiting blood may also be caused by more serious conditions such as internal injuries or an organ rupture.
Regurgitated blood may appear brown, dark red, or bright red in color. Brown blood often resembles coffee grains when vomited.
If you vomit a large amount of blood, or if you vomit blood in conjunction with dizziness or changes in breathing, call 911 immediately.
There are many causes of vomiting blood. They range in severity from minor to major and are normally the result of an injury or illness.
Vomiting blood may be caused by minor conditions such as:
- esophagus irritation
- swallowing blood
- tear in the esophagus due to chronic coughing
Other common causes of vomiting blood include:
- stomach ulcers
- aspirin side effects
- non-steroidal anti-inflammatory drugs (ibuprofen) side effects
More serious causes of vomiting blood include:
- alcoholic hepatitis
- esophageal cancer
- erosion of the stomach lining
- pancreatic cancer
Children may also experience vomiting blood. This is usually caused by:
- swallowing a foreign object
- swallowing blood
- birth defect
All instances of vomiting blood should be reported to your doctor.
Several symptoms may be present along with vomiting blood. These symptoms include, but are not limited to:
- abdominal discomfort
- abdominal pain
- vomiting stomach contents
Vomiting blood can indicate a serious medical emergency. If you experience any of the following symptoms call 911:
- blurred vision
- changes in heartbeat
- changes in breathing
- cold skin
- clammy skin
- severe abdominal pain
- vomiting blood after an injury
Do not drive yourself to the doctor. Call 911.
There are many potential health issues that could cause you to vomit blood. To come to a diagnosis, your doctor will begin by asking you questions about your symptoms, and whether or not you were recently injured.
Your doctor may order an imaging test to look inside your body. Imaging scans reveal abnormalities in the body such as ruptured organs or abnormal growths. Common imaging tests used for these purposes are:
- CT scan (computed tomography scan)
- Endoscopy (looking into your stomach with a tube passed through your mouth)
- MRI (magnetic resonance imaging)
Your doctor may wish to do an upper endoscopy to look for blood in the stomach. This procedure is done when you are sedated. Your doctor will place a small, flexible tube into your nostril or your mouth and down into stomach and small intestine. A fiber optic camera in the tube allows your doctor to see the contents of your stomach and examine you internally.
A blood sample may be taken to check your complete blood count. This helps to assess the amount of blood lost. Additional tests may be ordered based on your blood count result.
Depending on the amount of blood lost, you may need a blood transfusion. A blood transfusion replaces your lost blood with donor blood. The blood is fed into your vein through an intravenous (IV) line.
You might also require fluid to be given through an IV to rehydrate your body. Your doctor may provide you with medication to stop vomiting or to decrease stomach acid. If you have an ulcer, your doctor will prescribe medications to treat it. In severe cases, surgery may be needed. Such severe cases may include a bleeding ulcer or internal injuries.
If certain foods may increase the likelihood of vomiting blood, your doctor will devise a special diet geared to decrease this risk.
Choking is the main complication of vomiting blood. Depending on the cause, vomiting blood may cause additional health complications.
Anemia is a deficiency of healthy red blood cells and is another complication of excessive bleeding, particularly when the blood loss is rapid and sudden.
Vomiting blood caused by excessive bleeding can also lead to shock. The following symptoms are indicators of shock:
- dizziness upon standing
- rapid breathing
- shallow breathing
- low urine output
- cold, pale skin
If not treated immediately, shock can lead to a decrease in blood pressure followed by coma and death. If you experience any symptoms of shock, have someone take you to the emergency room or call 911.