Bloody Nose and Vomiting: What You Should Know

Blood from the nose can run backward into the throat and be swallowed, especially while lying down. The swallowed blood may upset the stomach and appear in vomit as red blood or dark, coffee-ground-like material. Vomiting itself can irritate the throat and nose, so the two symptoms may reinforce each other.

A nosebleed can follow dry air, nose picking, an injury, or irritation. Vomiting can also occur with illnesses such as gastroenteritis, food poisoning, migraine, or other conditions. The appearance and amount of blood, how long symptoms last, and whether the blood clearly came from the nose help a clinician assess the cause.

Sit upright and lean slightly forward so blood leaves through the nose rather than the throat. Pinch the soft part of the nose continuously for several minutes while breathing through the mouth. Do not tilt the head back or repeatedly release the pressure to check the bleeding.

Once the bleeding settles, take small sips of clear fluid if you can keep them down. Avoid forceful nose blowing, picking the nose, and heavy exertion for the rest of the day. Keep track of whether the vomit contains fresh red blood or dark material, and note any medicines that may increase bleeding.

Get emergency help for bleeding that is heavy or does not stop with steady pressure, vomiting a large amount of blood, fainting, confusion, trouble breathing, severe weakness, severe abdominal pain, or black stools. Seek urgent assessment after a significant head or face injury, or if you take a medicine that affects blood clotting.

Arrange prompt medical advice if vomiting continues, you cannot keep fluids down, you have signs of dehydration such as very little urine or marked dizziness, or nosebleeds keep returning. Children, older adults, and people with significant medical conditions may need earlier assessment.

Ask whether the blood most likely came from the nose, throat, or stomach; whether your medicines could contribute; and what warning signs should prompt emergency care. Tell the clinician when the bleeding and vomiting began, how often they occurred, what the blood looked like, and whether you had pain, fever, dizziness, or a recent injury.