Bright red blood in vomit

Fresh-looking blood may come from the oesophagus, stomach or the first part of the small bowel. Possible causes include a tear after forceful vomiting, an ulcer, inflamed tissue, enlarged veins, a bleeding disorder or medication that increases bleeding. Oesophageal cancer and stomach cancer can present with vomiting blood, but the symptom has other possible causes and cannot identify cancer on its own. Blood swallowed from a heavy nosebleed or bleeding in the mouth can sometimes later be vomited, yet medical assessment is still needed to establish the source.

Seek urgent medical help now rather than waiting to see whether bleeding returns. Do not drive yourself if you feel faint, weak, confused or short of breath; call emergency services. Sit or lie somewhere safe while help is arranged, and avoid eating or drinking until a clinician or emergency dispatcher advises you. Bring an up-to-date medication list, especially noting blood thinners, anti-inflammatory pain medicines and cancer treatments. If practical, describe the colour and appearance of the vomit, but do not delay care to collect a sample or photograph.

Call emergency services immediately if vomiting blood occurs with fainting, confusion, severe weakness, rapid or difficult breathing, cold clammy skin, severe chest or abdominal pain, or black tar-like stool. Repeated vomiting of blood or bleeding that seems heavy also needs an emergency response. These signs can accompany substantial blood loss or another serious problem. A person who becomes drowsy should be placed on their side if safe to do so, and should not be given food, drink or tablets by mouth while awaiting help.

Tell the clinician when bleeding began, whether retching came first, whether stool has turned black, and whether you have swallowing difficulty, abdominal pain, liver disease or recent procedures. Ask what source of bleeding is suspected, which tests are needed, whether any regular medicines should be paused, and what signs should trigger a return after discharge. Do not stop a prescribed blood thinner without direct clinical instructions unless emergency personnel advise it.