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Vomiting blood
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
Vomiting blood (hematemesis) can indicate a life-threatening condition, so promptly identifying the cause is essential. While vomiting blood may be caused by swallowed blood, as from a nosebleed or forceful coughing, truly vomiting blood usually represents something more serious and requires immediate medical attention. Bleeding in your upper gastrointestinal tract (mouth, esophagus, stomach and upper small intestine) from peptic ulcers or torn blood vessels is a common cause of vomiting blood. Blood in vomit may be bright red, or it may appear black or dark brown like coffee grounds. Call 911 if vomiting blood causes dizziness after standing, rapid, shallow breathing or other signs of shock.
Causes
Vomiting blood may be caused by:
- Acute liver failure
- Alcoholic hepatitis
- Aspirin
- Benign tumors of the stomach or esophagus
- Cirrhosis
- Defects in gastrointestinal tract blood vessels
- Duodenitis
- Esophageal cancer
- Esophageal varices
- Esophagitis
- Gastric erosions
- Gastric varices
- Gastritis
- Mallory-Weiss tear
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Pancreatic cancer
- Pancreatitis
- Peptic ulcer
- Portal hypertension
- Prolonged or vigorous vomiting
- Stomach cancer
- Swallowed blood
Causes
In infants and young children, vomiting blood may also result from:
- Birth defects
- Blood clotting disorders
- Milk allergy
- Swallowed object
When to see a doctor
Call 911 or emergency medical assistance
Seek emergency help immediately if you're vomiting blood and have any signs of severe blood loss or shock:
- Rapid, shallow breathing
- Dizziness or lightheadedness after standing up
- Blurred vision
- Fainting
- Confusion
- Nausea
- Cold, clammy, pale skin
- Low urine output
Seek immediate medical attention
Ask someone to drive you to urgent care or the emergency room if you notice blood in your vomit or begin vomiting blood. It's important to quickly identify the underlying cause of the bleeding and prevent more severe blood loss and other complications.
- Jutabha R, et al. Major causes of upper gastrointestinal bleeding in adults. http://www.uptodate.com/home/index.html. Accessed Feb. 16, 2009.
- Gralnek IM, et al. Management of acute bleeding from a peptic ulcer. New England Journal of Medicine. 2008;359:928.
- Hematemesis. Reston, Va.: American College of Radiology. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria/pdf/Vascular/HematemesisDoc12.aspx. Accessed Feb. 16, 2009.
- Jutabha R, et al. Approach to the adult patient with upper gastrointestinal bleeding. http://www.uptodate.com/home/index.html. Accessed Feb. 16, 2009.
- Villa X. Approach to upper gastrointestinal bleeding in children. http://www.uptodate.com/home/index.html. Accessed Feb. 16, 2009.
