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Overview of Vomiting Blood: Meaning, symptoms, causes & treatment

Team AckoJan 17, 2024

Vomiting is an uncomfortable sensation in itself that leaves you with a bitter taste in the mouth and burning in the chest. Seeing blood in the vomit only makes the experience more difficult. Vomiting of blood, medically termed Hematemesis, is a symptom of some disease in the gut. The blood can be bright red or dark brown, it may be just a few drops or a large quantity; however, one constant factor is that any blood when you throw up should never be ignored.

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What is Vomiting Blood?

Vomiting Blood is a condition in which blood is present in your vomit due to any reason. Fresh red blood in vomit usually comes from the upper part of your Gastrointestinal (GI) tract which includes the mouth, stomach, and the pipe that connects them called the oesophagus. This is a serious condition that requires urgent medical intervention. 

What does blood in vomit look like?

Hematemesis can present as vomiting of fresh blood which appears bright red and is indicative of ongoing, active bleeding from the upper gastrointestinal tract. Other times, it can present as dark, reddish brown, clumped-up vomitus which is referred to as coffee ground vomitus. This occurs when bleeding occurs in the upper GI tract, and the blood mixes with the gastric acid which oxidises it, causing it to become darker and resemble ground coffee.  

Causes of Vomiting Blood

Here are the main causes of Vomiting Blood. 

1. Ulcers 

If you experience constant heartburn, frequently get acidity, and feel nauseous or bloated, you may have a gastric ulcer. These can also cause Vomiting Blood. An ulcer is a wound because the surface layers of the structure get eroded and destroyed, exposing the underlying structures. Ulcers can occur in the stomach (gastric ulcer) and in the first part of the small intestine (duodenal ulcers). There are many causes for these ulcers, including the following.

  • H. pylori infection: A bacteria called Helicobacter pylori causes infection resulting in peptic ulcer disease.

  • Overuse of Non-steroidal anti-inflammatory drugs(NSAIDs): This is especially for those people who have a habit of taking painkillers daily for several years. Examples include ibuprofen, indomethacin, diclofenac, naproxen, etc. 

  • Stress: Unmanageablestress can cause such a situation.  

  • Zollinger Ellison Syndrome: A rare condition involving acid-producing tumours of the stomach.

The ulcer can cause bleeding either because it directly erodes into a blood vessel or because continuous retching or vomiting can damage the lining of the oesophagus.

An untreated ulcer can cause severe blood vomiting to such an extent that it can be life-threatening. It can also perforate and spill acid and blood into the entire abdominal cavity causing serious harm to life. 

2. Liver disease 

There are many conditions that can cause liver failure, such as chronic alcoholism, hepatitis B & C infections, autoimmune conditions, etc. Liver failure results in a condition called portal hypertension where the blood pressure inside the vessels supplying the liver becomes very high. This causes an increase in pressure in the backflow. As these portal vessels join vessels in the oesophagus and stomach, these vessels in the GI tract can rupture as a result of high pressure and cause profuse blood vomiting. This is an emergency and life threatening condition. 

3. Inflammation of different parts of the upper GI tract

  • Esophagitis

  • Gastritis

  • Duodenitis

All these conditions, when left untreated, can cause blood vomiting. 

4. Mallory-Weiss syndrome

When people have severe vomiting, due to excessive, violent retching, they can cause a tear in the junction of the oesophagus and stomach. This condition is called Mallory-Weiss Syndrome or Gastro-esophageal Laceration Syndrome. This presents with blood vomiting. This is more commonly seen in alcoholics and patients suffering from eating disorders. 

5. Cancers and tumours affecting parts of the gastrointestinal tract

Blood vomiting can be a sign of underlying cancer. It may be associated with other symptoms like loss of weight, poor appetite, swelling in the abdomen, and altered bowel habits. It can be seen in the following.

  • Gastric cancers

  • Cancer of pancreas 

  • Esophageal cancer 

6. Bleeding Disorders

The body has many mechanisms by which it prevents inappropriate bleeding and clotting. Sometimes there is a failure of these mechanisms, which can result in sudden spontaneous bleeding from any part of the body. Sometimes this can present as blood vomiting, especially in infants and children. Additionally, a deficiency of Vitamin K, which is essential for the production of these clotting factors, can also cause bleeding. 

Note: Minor bleeding after dental procedures or a nosebleed may result in the swallowing of some blood. If you vomit blood after that it may be normal. Make sure to disclose any such history to your doctor.

What to do when faced with an episode of Vomiting Blood

Seeing blood in your vomit for the first time is scary to say the least, especially if you don’t have any associated problems. Here is what you should do if that happens.

  • Seek medical help immediately. Preferably seek emergency care at a bigger, tertiary care hospital with a gastroenterology department.

  • Make sure to inform your doctor about any underlying diseases, use of medications for other conditions, and any family history of gastrointestinal diseases.

  • The procedure that is done to both diagnose as well as arrest active bleeding in the GI tract is called an Endoscopy. An endoscopy involves passing a flexible tube-like camera into your GI tract through your mouth. It can visualise the site of the bleeding, take a biopsy, or perform procedures to control the bleeding. 

  • When there is significant blood loss, the body goes into a state known as shock. This is a life-threatening condition. Most of the time when a patient presents with Vomiting Blood, there is a significant amount of blood that is lost. These patients require ICU care and may require blood transfusions to replenish the blood that was lost. 

It is therefore important to remember that blood vomiting is a serious issue that requires immediate medical attention. The earlier the diagnosis, the easier it is to manage the problem. If you or your family/peer faces such an issue, seek medical help immediately. 

What is the treatment for Vomiting Blood?

The treatment for Vomiting Blood depends on the underlying cause. Initial treatment usually involves giving medication to stop the vomiting and reduce the production of gastric acid. 

Some conditions such as ulcers can be treated with medical management alone. However, cases, where there is a chance that the gut tissue may rupture, may require urgent surgery.

Frequently Asked Questions

Here’s a list of common questions related to Vomiting Blood.

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How can I know if I am Vomiting Blood?

As blood in the vomit may not always be bright red, it can be a little confusing to understand. However, if you experience any severe pain while vomiting, frequent vomiting, or retching, it is best to consult a doctor at the earliest.

Can forcing yourself to vomit cause bleeding?

Disorders in which patients induce vomiting using their fingers or any other object are a common cause of vomiting of blood and could indicate an injury to the gut. A psychologist or psychiatrist can help treat such disorders.

I have been drinking alcohol for several years. However, yesterday I saw blood in my vomit for the first time. What could be the reason?

Chronic alcoholism causes liver damage that can gradually affect the blood vessels as well. In case of frequent drinking, it is recommended to always eat first, avoid smoking at the same time, and avoid drinking altogether while on medication. 

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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