A little blood in vomit

Fresh blood may look bright red, while partially digested blood can resemble dark coffee grounds. Contact an urgent medical service now for advice; emergency care is appropriate if bleeding recurs or you feel weak, dizzy, breathless or unwell.

Blood mixed with vomit commonly comes from the oesophagus, stomach or upper small bowel. Causes include irritation after forceful retching, inflammation, an ulcer, enlarged veins or medicines that increase bleeding. Swallowed blood from a nosebleed or mouth injury can sometimes appear in vomit as well.

Stomach cancer and oesophageal cancer can present with vomiting blood, but this symptom does not identify the cause. A clinician may need a blood count, medicine review and an endoscopic examination to find the source and judge whether bleeding is ongoing.

Note the colour and approximate amount, whether the vomit looked like coffee grounds, and whether your stool is black or sticky. Bring a current medicine list, particularly blood thinners, aspirin or anti-inflammatory pain medicines. Do not take an extra dose or stop a prescribed blood thinner on your own; the assessing clinician needs to balance bleeding and clotting risks.

Call emergency services for more than a streak of blood, repeated vomiting of blood, coffee-ground material, black sticky stools, fainting, confusion, cold clammy skin, rapid breathing, severe abdominal or chest pain, or marked weakness. Lie on your side if you may vomit again, do not drive yourself, and avoid food or drink while awaiting emergency instructions.

Ask where the bleeding is thought to have started, whether an endoscopy is needed, how your regular medicines should be handled, what changes in vomit or stool require a return to emergency care, and when follow-up results will be available.