Vomiting Blood

Overview

Why am I vomiting blood?

Vomiting blood, also called hematemesis, is a serious condition in which blood is expelled from the mouth. The blood can be bright red, black or dark brown. Conditions that cause a person to vomit blood can also cause blood to show up in the stool.

Vomiting blood does not refer to slight amounts of blood that might show up in your spit after brushing your teeth or after a nosebleed or a gum injury. (This is spitting up blood.) Vomiting blood also does not refer to blood that comes from the lungs, as might happen with illnesses such as bronchitis, pneumonia or lung cancer. Coughing up blood is called hemoptysis.

Possible Causes

What causes vomiting blood?

Blood that is vomited usually comes from what is referred to as the upper GI, or gastrointestinal, tract. This includes the esophagus, stomach and duodenum (upper part of the small intestine). Pancreatic problems can also be the source of blood vomiting.

There are several causes of vomiting blood. Most of them are very serious and require immediate medical attention.

Causes can include:

  • A tear (called a Mallory-Weiss tear) in the lining of the esophagus, caused by excessive vomiting
  • Swollen veins (varices) in the lower part of the esophagus and stomach. This often happens in people with severe liver damage, including people with long-term alcoholism.
  • A bleeding stomach or duodenal ulcer
  • Irritation or swelling of the esophagus, called esophagitis
  • A benign (non-cancerous) or cancerous tumor in the stomach or esophagus
  • A severe injury to the abdominal area, as caused by a car accident or blow to the abdomen
  • An inflammation of the stomach, called gastritis
  • Taking too much aspirin or nonsteroidal anti-inflammatory medicines
  • A condition called Dieulafoy's lesion that affects an artery in the stomach wall
  • Inflammation of the small intestine, called duodenitis
  • Pancreatic cancer

Care and Treatment

What should I do if I am vomiting blood?

Vomiting blood is a very serious medical condition. You should seek immediate medical attention if you are vomiting blood. Call 911 if you are vomiting blood and also feel dizzy, faint, or light-headed, or if you are having problems breathing.

How is vomiting blood treated?

If you are vomiting blood your medical team will first try to stabilize any low blood pressure, breathing problems or other complications of excessive blood loss. You may require a blood transfusion, breathing assistance and medication for your blood pressure or to lower stomach acid levels. You may also require IV (given through the veins) fluids, and possibly surgery.

Once a patient is stable, the cause of vomiting blood will be addressed. To determine the cause, several tests may be performed. These include:

  • Blood tests to do complete blood count, check blood chemistry and clotting function
  • Liver function tests
  • X-rays
  • A nuclear medicine scan to look for any active bleeding in the GI tract
  • A rectal examination
  • Inserting a tube through the nose down to the stomach to check for the cause of blood loss
  • A test called a esophagogastroduodenoscopy (EGD) to look for sources of bleeding in the upper GI tract

Once the cause of vomiting blood is determined, your physician will determine the best treatment plan that will address both your symptoms and the underlying condition causing the vomiting.

Last reviewed by a Cleveland Clinic medical professional on 01/16/2018.

References

  • Furyk JS, Meek RA, Egerton-Warburton D. Drugs for the treatment of nausea and vomiting in adults in the emergency department setting. (https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0079133/) Cochrane Database of Systematic Reviews 2015, Issue 9. Accessed 2/14/2018.
  • NHS Choices. Vomiting Blood. (haematemesis) (https://www.nhs.uk/conditions/vomiting-blood/) Accessed 2/14/2018.
  • U.S. Department of Health and Human Services. Talk to Your Doctor about Abdominal Aortic Aneurism. (https://healthfinder.gov/healthtopics/category/doctor-visits/screening-tests/talk-to-your-doctor-about-abdominal-aortic-aneurysm) Accessed 2/14/2018.

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