Vomiting blood (haematemesis) 

  • Overview

Introduction 

Vomiting blood is a medical emergency – it means there is bleeding somewhere in your gullet, stomach or the first part of your bowel. You should see your GP immediately.

The amount and colour of blood can vary:

  • you might have vomited large amounts of bright red blood
  • there might just be streaks of blood in your vomit, mixed up with food
  • you may find what look like coffee grounds in your vomit – this means the blood has been in your stomach for a few hours

It's important not to get rid of the vomit. Your GP will have a much better idea of what's wrong if they can view a sample of it.

Unless you are perfectly well and the cause is obvious to your GP (for example, swallowing blood from a nosebleed), you should be admitted straight to hospital for tests. These include blood tests and an endoscopy (where a thin, flexible tube is passed into your body via your throat – to examine the inside of your digestive tract).

It is important to be certain that you have vomited up the blood (it has come from your stomach or gullet) and not coughed it up from your airways or lungs, which would indicate a completely different problem. Read about coughing up blood.

The rest of this page summarises the most likely causes of blood in the vomit, which is known medically as haematemesis. It is a rough guide that should give you a better idea of the problem, but do not use it to diagnose yourself – always leave that to your GP.

Common causes of vomiting blood

The most common causes of blood in the vomit are:

  • peptic ulcer or severe gastritis (inflammation of the lining of the stomach) – an ulcer is the most likely cause 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 – these are enlarged veins in the walls of the lower part of the oesophagus (gullet) that bleed, but should not cause any pain. They are often caused by alcoholic liver disease. If your GP thinks this is the cause, you'll need an ambulance to take you straight to hospital.
  • Severe gastro-oesophageal reflux disease, where stomach acid has irritated your oesophagus.
  • A tear in the lining of your oesophagus caused by prolonged retching.
  • Swallowed blood (for example, from a severe nosebleed). 

You can click on the above links for more information on these conditions.

The above conditions may also cause you to have blood in your stools (black, tarry poo).

Less common causes

Less commonly, vomit in the blood may be a result of:

  • Swallowing poisons such as corrosive acid or arsenic – read more about poisoning
  • A blood disease such as thrombocytopenia, leukaemia, haemophilia or anaemia
  • Cancer of the oesophagus or stomach cancer. Your GP may suspect cancer if you are over 55 and have also lost a lot of weight (it is otherwise rare). 

Page last reviewed: 12/07/2012

Next review due: 12/07/2014

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The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Annwyn49 said on 20 July 2014

My mother, who was 82, went into hospital with a broken arm which could not be set as the break was near the shoulder. She needed a lot of painkillers, including Ibuprofen but within 1day of being admitted she had gone off her food and was feeling sick. A day later she vomited coffee grounds and was put on a drip. Within another 2days we were told her kidneys had failed and nothing more could be done. She died two weeks to the day she went in. She was driving the day before being admitted and living on her own. It was so sudden. Somone who worked in care homes told me the elderly often vomit coffee grounds in their last weeks. Was it normal for someone who hadn't eaten much for only two days to have this reaction or did it indicate another condition? She did not have a post mortem carried out and I am still trying to make sense of her rapid and fatal decline.

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AndyC89 said on 08 February 2014

The past week I've been feeling really unwell and thrown up a lot of blood, when I went to Rochdale Urgent Care Centre they examined me and said there's nothing wrong with me and I don't need to be worried about anything. I also have white/clay coloured poo with blood in which I mentioned but they said it was nothing. The most physical problem I've got is a hernia which feels strangulated and is really sensitive when touched, the hernia is red and has turned purple. The nurses at Rochdale Urgent Care Centre said it doesn't need emergency treatment then they discharged me. I've also been fainting a lot as well. Not sure if the NHS rules have changed and the details on here are old but from what I was told that seems to be the case.

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