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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.
It may be hard to tell the difference between vomiting blood and coughing up blood (from the lung) or a nosebleed.
Conditions that cause vomiting blood can also cause blood in the stool.
The upper GI (gastrointestinal) tract includes the mouth, throat, esophagus (swallowing tube), stomach and the duodenum (first part of the small intestine). Blood that is vomited may come from any of these places.
Vomiting that is very forceful or continues for a very long time may cause a tear in the small blood vessels of the throat. This may produce streaks of blood in the vomit.
Swollen veins in the walls of the lower part of the esophagus, and sometimes the stomach, may begin to bleed. These veins (called varices) are present in people with severe liver damage.
Other causes may include:
- Bleeding ulcer in the stomach, first part of the small intestine, or esophagus
- Blood clotting disorders
- Defects in the blood vessels of the GI tract
- Swelling, irritation, or inflammation of the esophagus lining (esophagitis) or the stomach lining (gastritis)
- Swallowing blood (for example, after a nosebleed)
- Tumors of the mouth, throat, stomach or esophagus
Common causes of vomiting blood
The most common causes of vomiting blood are discussed below.
- Stomach ulcer or severe gastritis
A stomach ulcer or severe gastritis (stomach lining inflammation) are the most likely cause of vomiting blood if you also have a burning or gnawing pain in your tummy.
Bleeding occurs when the ulcer or inflammation damages an underlying artery.
- Oesophageal varices
Oesophageal varices are enlarged veins in the walls of the lower part of the oesophagus (gullet) that bleed but don’t usually cause any pain.
They’re often caused by alcoholic liver disease. If your GP or doctor suspects that oesophageal varices are the cause of blood in your vomit, you’ll need to be admitted to hospital immediately.
- Severe gastro-oesophageal reflux disease
Gastro-oesophageal reflux disease (GORD) is where acid leaks out of the stomach and up into the oesophagus.
If you have severe GORD it can irritate the lining of your oesophagus and cause bleeding.
- Tear in the oesophagus
Prolonged retching can tear the lining of your oesophagus, which can also result in bleeding.
- Swallowed blood
It’s possible to swallow blood in certain circumstances – for example, after a severe nosebleed.
The above conditions may also cause you to have blood in your stools (causing black, tarry poo).
Treatment Home Care
Get medical attention right away. Vomiting blood can be a result of a serious medical problem.