Bleeding from vomiting: what to know

Fresh red blood can be visible after forceful or repeated vomiting has irritated the throat or upper digestive tract. Brown or grainy material resembling coffee grounds can represent blood that has been exposed to stomach acid. Causes can also include an ulcer, inflammation, or another source of upper digestive bleeding. Food poisoning, gastroenteritis, and pancreatitis may cause vomiting, but the appearance of blood requires separate attention.

The amount, colour, timing, and recurrence matter. Tell the clinician about black stools, upper-abdominal pain, faintness, alcohol use, liver disease, and medicines such as aspirin or anti-inflammatory painkillers.

Contact emergency medical services or go to an emergency department for assessment. Do not eat or drink large amounts while actively vomiting; if you are alert and waiting for help, follow the dispatcher’s instructions. Avoid alcohol and do not take aspirin or anti-inflammatory painkillers unless a clinician specifically advises you. Bring or list your medicines, and note what the vomit looked like.

Call emergency services immediately for more than a small streak of blood, repeated bloody vomiting, coffee-ground vomit, black sticky stool, severe abdominal or chest pain, fainting, confusion, marked weakness, clammy skin, or breathing difficulty. Emergency help is also needed if you cannot keep fluids down or are passing very little urine. Do not drive if you feel dizzy or weak.

Ask where the bleeding may be coming from, whether tests or a camera examination are needed, and whether any current medicine could be contributing. Ask what you may eat or drink during recovery and which symptoms mean you should return immediately.