What should you know about bloody emesis?

The blood may look bright red, dark brown, or like coffee grounds. Even a small-looking amount can be difficult to judge at home, so do not ignore it or wait for it to happen again.

Vomiting blood can come from bleeding in the oesophagus, stomach, or the first part of the small intestine. Forceful retching may irritate or tear tissue, while ulcers, inflammation, liver-related vein changes, or swallowed blood from the nose or mouth can also be involved.

Food poisoning, gastroenteritis, gallstones, pancreatitis, or migraine may cause vomiting, but blood in the vomit changes the urgency and should be assessed rather than attributed to a stomach bug. The appearance of the blood and associated symptoms help a clinician identify the likely source.

Stop eating and drinking until you have received medical advice, unless an emergency clinician tells you otherwise. Sit upright or lie on your side if you feel faint, and do not drive yourself if you are weak or light-headed.

Note the colour and approximate amount, when it began, and whether you have abdominal pain, black stools, fever, or repeated retching. Take a photo if safe and practical. Bring a list of medicines, particularly aspirin, anti-inflammatory painkillers, or blood thinners.

Seek emergency care immediately for ongoing or heavy bleeding, fainting, confusion, pale clammy skin, rapid breathing, severe abdominal or chest pain, or trouble staying awake. Black, tar-like stools can also indicate digested blood.

Arrange urgent same-day assessment even if the bleeding has stopped. A clinician may check circulation and blood tests, then decide whether imaging or an upper digestive-tract examination is needed. Do not take leftover medicines to treat the bleeding without advice.

Ask what source of bleeding is most likely, whether any medicine should be stopped or changed, and which warning signs should prompt a return to emergency care. Also ask when it is safe to resume fluids and food.