Black vomit and acid reflux: what it means

Blood that remains in the stomach can look dark brown or like coffee grounds after contact with acid. Acid reflux commonly causes burning behind the breastbone, sour fluid, or regurgitation, but black vomit raises a separate concern for bleeding in the upper digestive tract. Swallowed blood or dark material can also alter vomit, so a clinician must assess the history and appearance.

Stop eating and drinking large amounts while arranging urgent medical help, especially if vomiting continues. Keep a record or photograph of the vomit if safe, and take your medicine list with you. Do not take aspirin or other anti-inflammatory pain relievers unless a clinician has specifically instructed you. Reflux symptoms such as cough or chest discomfort should not distract from the black vomit.

Call local emergency services for black or coffee-ground vomit with fainting, severe weakness, confusion, fast breathing, cold clammy skin, severe abdominal pain, or fresh blood. Emergency assessment is also needed if you cannot keep fluids down or have black tarry stool. Do not drive if dizzy or faint.

Ask whether reflux, a hiatus hernia, or another upper digestive problem could be contributing to your symptoms, and which treatment is safe after bleeding has been considered. Explain when the vomiting began and mention abdominal pain, chest tightness, cough, alcohol, and every medicine or supplement.