Blood spots in vomit: what they may mean and when to get help

Fresh blood can look bright red or streaky, while older blood may look dark or grainy. Food colouring can sometimes resemble blood, but do not rely on appearance alone when bleeding is possible.

Forceful retching can irritate or tear tissue near the throat or where the food pipe meets the stomach. Blood may also be swallowed from a nosebleed, bleeding gums, or a mouth injury before it appears in vomit.

Other causes include inflammation, an ulcer, or bleeding elsewhere in the upper digestive tract. The amount and colour cannot identify the source reliably, so a clinician may need to examine you and review your medicines and symptoms.

Stop eating and drinking until you have received medical advice, especially if vomiting is continuing. Keep a note of the blood's colour, approximate amount, and whether it followed repeated retching, a nosebleed, pain, or an injury.

Arrange prompt medical assessment even if the bleeding seems small or has stopped. Tell the clinician about aspirin, anti-inflammatory painkillers, blood-thinning medicines, alcohol use, liver problems, ulcers, and any recent procedures.

Call emergency services for a large amount of blood, repeated bloody vomiting, black or grainy vomit, black stools, severe chest or abdominal pain, trouble breathing, fainting, confusion, marked weakness, clammy skin, or a rapid heartbeat.

Do not drive yourself if you feel faint or weak. Lie on your side if vomiting continues and have someone stay with you while help is arranged.

Ask whether your medicines could increase bleeding, whether blood tests or examination of the digestive tract may be needed, and what food or fluids are appropriate afterward. Mention any nose, mouth, or skin bleeding as well as easy bruising.