Hematemesis; Blood in the vomit
The upper GI (gastrointestinal) tract includes the mouth, throat, esophagus (swallowing tube), stomach and the duodenum (first part of the small intestine). Blood that is vomited may come from any of these places.
Vomiting that is very forceful or continues for a very long time may cause a tear in the small blood vessels of the throat. This may produce streaks of blood in the vomit.
Swollen veins in the walls of the lower part of the esophagus, and sometimes the stomach, may begin to bleed. These veins (called varices) are present in people with severe liver damage.
Other causes may include:
It may be hard to tell the difference between vomiting blood and coughing up blood (from the lung) or a nosebleed.
Conditions that cause vomiting blood can also cause blood in the stool.
Vomiting blood is regurgitating (throwing up) contents of the stomach that contains blood.
Vomited blood may appear either a bright red or dark red color. The vomited material may be mixed with food or it may be blood only.
Get medical attention right away. Vomiting blood can be a result of a serious medical problem.
The provider will examine you and ask questions such as:
Tests that may be done include:
If you have vomited a lot of blood, you may need emergency treatment. This may include:
Call your health care provider or go to the emergency room if vomiting of blood occurs. You will need to be examined right away.
Goralnick E, Meguerdichian DA. Gastrointestinal bleeding. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 30.
Kovacs TO, Jensen DM. Gastrointestinal hemorrhage. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 135.
Savides TJ, Jensen DM. Gastrointestinal bleeding. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 20.
Review Date: 1/25/2017
Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 9-1-1 for all medical emergencies. Links to other sites are provided for information only—they do not constitute endorsements of those other sites. © 1997-2010 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.