Bleeding while vomiting: what should you know?

Repeated retching can cause a small tear or irritation in the throat or food pipe. Swallowed blood from a nosebleed can also appear in vomit. Bright-red blood suggests fresher bleeding, while dark material resembling coffee grounds may have been altered by stomach acid. Vomiting can accompany gastroenteritis, food poisoning, migraine, or other illnesses, but the appearance and cause cannot be confirmed at home.

Stop eating solid food while arranging advice, and take only small sips of water if you can swallow safely. Keep a note of the colour and amount of blood and any medicines you take, especially anti-inflammatory or clot-affecting medicines. Do not drink alcohol or take additional painkillers without advice. Have someone stay with you if you feel weak or dizzy.

Seek emergency help for any substantial amount of blood, coffee-ground material, black stools, faintness, confusion, rapid breathing, severe abdominal pain, or cold clammy skin. Urgent assessment is also needed if vomiting continues, you cannot keep fluids down, or you have known liver or digestive disease. Do not drive yourself if you feel faint.

Ask whether you need immediate examination, blood tests, or a procedure to locate bleeding. Tell the clinician about retching, abdominal pain, black stools, alcohol use, previous ulcers, liver problems, and every medicine or supplement you use.