Being sick and blood: what you should know

Bright-red streaks may appear when repeated vomiting irritates or tears small blood vessels in the throat. Dark brown or black material that resembles coffee grounds can indicate blood that has stayed in the stomach. Swallowed blood from a nosebleed or mouth injury can also be vomited. Conditions such as gastritis, a peptic ulcer, gallstones, pancreatitis, food poisoning, or gastroenteritis may need consideration alongside the colour and amount of blood.

Tell a clinician whether you also have severe tummy pain, black stools, dizziness, faintness, fever, headache, or a stiff neck. Vomiting with a severe headache can occur with migraine, while vomiting with fever and a stiff neck needs urgent attention because meningitis is a possible cause. In children, rotavirus infection can cause repeated vomiting and fluid loss.

Stop eating solid food briefly if vomiting is continuing, but take small, frequent sips of water or an oral rehydration drink if you can keep them down. Avoid alcohol and medicines such as ibuprofen or aspirin unless a clinician has told you to use them, as they can irritate the stomach or worsen bleeding. Keep a note of the colour, approximate amount, timing, and any medicines taken. Do not drive if you feel faint. Arrange prompt medical advice even if the blood stops, and take a photo of the vomit if it can be done safely.

Seek emergency care now for more than a small streak of blood, coffee-ground vomit, repeated bloody vomiting, faintness, confusion, rapid breathing, cold clammy skin, severe abdominal pain, or black tar-like stools. Get urgent help if you cannot keep fluids down or are passing very little urine. These signs can point to significant bleeding or dehydration. While waiting, lie on your side if you feel you may vomit again and ask someone to stay with you.

Ask: Could my vomiting have irritated my throat or stomach? Do my symptoms suggest an ulcer, infection, or another source of bleeding? Which pain medicines should I avoid? Do I need tests, observation, or treatment to replace fluids? What changes should bring me back immediately?