Vomiting blood (haematemesis) 

  • Overview

Introduction 

Haematemesis is the medical name for blood in the vomit 

Emergency services

Read about A&E departments and other emergency services available in the NHS, such as minor injury units or emergency contraception

Vomiting blood is a medical emergency and requires immediate medical assistance. Go to your GP surgery or your nearest accident and emergency (A&E) department.

Vomiting blood can be sign of a serious medical problem and needs to be investigated straight away.

If you vomit blood it means there's bleeding somewhere in your gullet, stomach or the first part of your small intestine (duodenum).

Haematemesis is the medical name for blood in the vomit. The amount and colour of blood can vary. For example:

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

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

Unless you're perfectly well and the cause is obvious to your GP or doctor (for example, swallowing blood from a nosebleed), you should be admitted to hospital straight away for tests.

These will include blood tests and an endoscopy. This is where a thin, flexible tube with a light and camera at one end (an endoscope) is used to examine the inside of your digestive tract.

It's important to confirm that the blood you've vomited has come from your stomach or gullet, and that you haven't coughed it up from your airways or lungs, which would indicate a completely different problem. Read about coughing up blood.

Below is a summary of the most likely causes of blood in the vomit. It's a rough guide that should give you a better idea of the problem. However, don't use it to diagnose yourself - always leave that to your GP or doctor.

Common causes of vomiting blood

The most common causes of vomiting blood are discussed below.

Stomach ulcer or severe gastritis

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 is 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 (black, tarry poo).

Less common causes of vomiting blood

Less commonly, blood in your vomit may be caused by:

  • swallowing poisons - such as corrosive acid or arsenic (read more about poisoning)
  • a blood condition - such as thrombocytopenia (a reduced number of platelets in the blood), leukaemia, haemophilia or anaemia
  • cancer of the oesophagus or stomach cancer - cancer may be suspected if you're over 55 and you've also lost a lot of weight (it's otherwise rare). 

Page last reviewed: 25/07/2014

Next review due: 25/07/2016

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Comments

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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Nosebleed

Nosebleeds are fairly common, particularly in children, and can often be treated at home