Black or coffee-ground blood in vomit

The dark appearance can develop when blood remains in the stomach and reacts with stomach acid. It is a warning of possible upper digestive bleeding, even when vomiting has stopped or the person does not see bright-red blood.

Possible sources include a bleeding ulcer, stomach inflammation, a tear after retching, or enlarged veins in the oesophagus or stomach. Oesophageal cancer and stomach cancer can also present with bleeding into the upper digestive tract. Dark vomit does not reveal which condition is responsible, so diagnosis requires clinical assessment.

Food and some medicines can darken vomit, but it is unsafe to assume they explain a coffee-ground appearance. Clinicians interpret the material alongside blood pressure, pulse, abdominal findings, bowel-movement colour, medicines, liver history, and blood-test results.

Seek urgent medical advice now. Preserve a photograph or small sample only if this can be done safely, and record when vomiting began, how often it occurred, and whether there were red streaks or clots. Bring a list of prescriptions, non-prescription pain medicines, supplements, and cancer therapies.

Have someone stay with you and arrange transport if the clinical service advises hospital assessment. Do not eat, drink, or change prescribed medicines solely on general advice; follow the instructions given by the emergency or treating team because tests or procedures may be required.

Call immediately if dark vomiting is continuing, or if it occurs with fainting, confusion, severe weakness, rapid or difficult breathing, chest or abdominal pain, cold clammy skin, very little urine, or black tar-like stools. Do not travel alone or drive when dizzy. While waiting, follow the call handler’s instructions and keep medicine packets available.

Ask how the bleeding source will be located, whether an endoscopic examination is being considered, what treatment may stop further bleeding, and when usual medicines can be taken again. If you have cancer, ask whether the episode changes the timing of your next treatment and which team will coordinate follow-up.