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Vomiting blood

Definition

Vomiting blood is a backward flowing (regurgitation) of blood through the upper gastrointestinal (GI) tract. The GI tract includes the small intestine, stomach, mouth, throat and esophagus, the tube that moves food and secretions from mouth to stomach.

Alternative Names

Hematemesis; Blood in the vomit

Considerations

Vomiting of blood results after there is upper gastrointestinal bleeding. This condition can sometimes be difficult to distinguish from coughing up blood (from the lung) or a nosebleed (bloody post-nasal drainage).

Conditions that cause blood to be vomited can also cause blood in the stool.

Common Causes

There are several reasons why someone may vomit blood. For example, vomiting that is very forceful or continues for a very long time may cause a tear in the small blood vessels of the throat or the esophagus, producing streaks of blood in the vomit.

Other causes may include:

  • Bleeding ulcer located in the stomach, duodenum, or esophagus
  • Bleeding esophageal varices
  • Defects in the blood vessels of the GI tract
  • Esophagitis
  • Gastritis
  • Gastroenteritis
  • Irritation or erosion of the lining of the esophagus or stomach
  • Swallowing blood (for example, swallowed after a nosebleed)
  • Tumors of the stomach or esophagus

Home Care

Although not all situations are the result of a major medical problem, this is difficult to know without a medical evaluation. Seek immediate medical attention.

Call your health care provider if

Call your doctor or go to the emergency room if vomiting of blood occurs -- this requires immediate medical evaluation.

What to expect at your health care provider's office

The doctor will examine you and ask questions such as:

  • When did the vomiting begin?
  • Have you ever vomited blood before?
  • How much blood was in the vomit?
  • What color was the blood?
  • Have you had any recent nosebleeds, surgeries, dental work, vomiting, stomach problems, or severe coughing?
  • What other symptoms do you have?
  • What medical conditions do you have?
  • What medicines do you take?
  • Do you drink alcohol or smoke?

Tests that may be done include:

  • Blood work, such as a complete blood count (CBC), blood clotting values, and liver function tests
  • Esophagogastroduodenoscopy (EGD)
  • Tube through the nose into the stomach to check for blood
  • X-rays

If you have vomited a lot of blood, emergency treatment may be needed. This may include:

  • Blood transfusions
  • Fluids through a vein
  • Medications to decrease stomach acid,
  • Possible surgery if bleeding does not stop

Review Date:11/13/2007
Reviewed By:Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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