Hematemesis is the medical terminology for vomiting blood. Vomiting blood regurgitates (vomits) bloody stomach contents. The vomited blood may appear as bright red, dark red, or look like coffee grounds. Vomiting can be mixed with food or just blood.
By Medicover Hospitals / 11 Mar 2021
What is Hematemesis?
Hematemesis or Vomiting blood is the regurgitation of stomach contents mixed with blood or the regurgitation of blood only. Vomiting blood can be caused for concern, but sometimes minor causes can trigger it. This includes ingestion of blood following an injury to the mouth or a nosebleed.
These minor situations are unlikely to cause any damage in the long term. Vomiting blood can also be caused by more serious conditions such as internal injury, organ bleeding, or organ rupture.
Regurgitated blood may appear brown, dark red, or bright red in color. Brown blood often looks like coffee grounds when vomited. The color of vomited blood can often show your doctor the source and severity of the bleeding.
For example, darker blood shows that the bleeding is from an upper gastrointestinal source, such as the stomach. Darker blood is a less intense and regular source of bleeding.
Bright red blood often shows an acute bleeding episode originating from the esophagus or stomach. This can be a source of rapid bleeding.
The color of the blood in the vomit may not always show the source and severity of the bleeding, but should always prompt your doctor to investigate.
If you vomit a large amount of blood, usually 500 cc or the size of a small cup, or if you vomit blood with dizziness or changes in breathing, call emergency immediately.
Causes
There are several causes of vomiting blood. Most of them are very serious and require immediate medical attention. The causes can include:
- A tear in the esophagus's lining, caused by excessive vomiting
- Swelling of the veins (varicose veins) in the lower part of the esophagus and stomach. This often occurs in people with severe liver damage, including people with long-term alcoholism.
- Stomach bleeding or duodenal ulcer
- Irritation or swelling of the esophagus called esophagitis
- A benign or cancerous tumor of the stomach or esophagus
- A serious injury to the abdominal area, caused by a car accident or a blow to the abdomen
- Inflammation of the stomach called gastritis
- Taking too much aspirin or nonsteroidal anti-inflammatory drugs
- A condition called Dieulafoy's lesion, which affects an artery in the wall of the stomach
- Inflammation of the small intestine called duodenitis
- Pancreatic cancer
Diagnosis
Many potential health problems could cause you to vomit blood. To make a diagnosis, your doctor will start by asking you about your symptoms and whether you've been recently injured.
Your doctor may order an imaging test to look inside your body. Imaging tests reveal abnormalities in the body, such as ruptured organs or abnormal growths. Common imaging tests used for these purposes are:
- CT scan
- Endoscopy, a device that allows your doctor to look into your stomach
- Ultrasound
- X-ray
- MRI
Your doctor may order an upper endoscopy to look for blood in the stomach. This procedure is performed while you are sedated. Your doctor will place a small flexible tube called an endoscope in your mouth and your stomach and your small intestine.
A fiber-optic camera in the tube allows your doctor to see the contents of your stomach and examine you internally for any source of bleeding.
Your doctor may order a blood test to check your complete blood count. This helps assess the amount of blood lost. A biopsy may also be done to determine if the source of the bleeding is an inflammatory, infectious, or cancerous source. Your doctor may order additional tests depending on your blood count result.
Treatment
If you vomit blood, your healthcare team will first try to stabilize any low blood pressure, breathing problems, or other complications from excessive blood loss. You may need a blood transfusion, breathing help, and medicine for your blood pressure or to lower stomach acid levels. You may also need IV fluids and possibly surgery.
Once a patient is stable, the cause of vomiting blood will be treated. To determine the cause, several tests can be performed. These include:
- Blood tests to take a complete blood count, check blood chemistry and clotting function
- Liver function tests
- X-rays
- A nuclear medicine scan to look for any active bleeding in the gastrointestinal tract
- A rectal exam
- Insertion of a tube through the nose into the stomach to check for the cause of the blood loss
- A test called an esophagogastroduodenoscopy (EGD) to look for sources of bleeding in the upper digestive tract
Once the cause of the vomiting blood is determined, your doctor will determine the best treatment plan that will address both your symptoms and the underlying condition causing the vomiting.
Once the cause of the vomiting blood is determined, your doctor will determine the best treatment plan that will address both your symptoms and the underlying condition causing the vomiting.
When to visit a Doctor?
Seek immediate care when you have:
- You vomit large amounts of blood or vomit several times in a row.
- You have severe abdominal pain.
Contact your doctor immediately when:
- You have new or worsening symptoms.
- You have questions or concerns about your condition or your care.
Immediately call for an emergency.
Citations
Biliary Tract Hemorrhage as a Cause of Hematemesis
Hematemesis and Melena: With Special Reference to Causation and to the Factors Influencing the Mortality from Bleeding Peptic Ulcers*
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Frequently Asked Questions
1. What is the difference between Haemoptysis and Haematemesis?
Hemoptysis is the coughing of blood from the airways below the level of the larynx. Hemoptysis should be differentiated from hematemesis is vomiting of blood from the gastrointestinal (GI) tract.
2. Can alcohol Hematemesis?
Regular overuse of alcohol can cause liver scarring and other medical conditions. The blood vessels can then burst, causing excess blood in the vomit. Weakness, fainting, and rectal bleeding may also accompany hematemesis.
3. Is coffee ground emesis the same as Hematemesis?
Ground coffee vomit is vomit that looks like coffee grounds. This happens because of the clotted blood in the vomit. Vomiting blood is also known as hematemesis or ground coffee vomiting.
