Alcohol and throwing up blood: what to do

Call emergency services or go to the nearest emergency department now. Do not drive yourself. Even if the bleeding appears to stop, the cause still needs prompt assessment because internal bleeding can restart or continue without being obvious.

Blood may be bright red, mixed with vomit, or dark and grainy like coffee grounds. Heavy retching can tear the lining where the oesophagus meets the stomach. Alcohol can also irritate the stomach lining, and long-term heavy drinking can contribute to liver damage and enlarged veins in the oesophagus that may bleed.

The appearance or amount cannot reliably identify the source at home. Swallowed blood from a nosebleed can sometimes be vomited, but that possibility should not delay care when the source is uncertain.

Stop drinking alcohol and do not eat or drink while waiting for emergency advice, as a procedure may be needed. Sit upright if awake; if the person becomes drowsy but is breathing, place them on their side to reduce the chance of choking. Keep any medication list available and tell clinicians about alcohol intake, liver disease, ulcers, and medicines that affect bleeding.

Do not take aspirin or ibuprofen for discomfort unless an emergency clinician specifically directs you. Never leave an intoxicated, bleeding, confused, or very sleepy person alone.

Any vomited blood warrants emergency assessment. Tell the dispatcher immediately if there is fainting, confusion, clammy or pale skin, rapid breathing, severe weakness, abdominal pain, black sticky stools, difficulty waking, or trouble breathing. These signs can accompany major blood loss, aspiration, or serious alcohol-related illness.

If breathing stops, begin CPR if you know how and follow the emergency dispatcher's instructions. Do not try to make the person vomit.

Ask where the bleeding came from, whether tests showed stomach or liver damage, which medicines to avoid, and what follow-up is required. If cutting down alcohol causes shaking, sweating, agitation, or seizures, explain this clearly: withdrawal can need supervised treatment rather than an unsupported attempt to stop.