Chunks of blood in vomit

Blood can form soft clots after collecting in the stomach, so vomit may contain red chunks. Blood exposed to stomach acid can instead look dark brown or like coffee grounds. Either appearance can represent bleeding from the oesophagus, stomach or first part of the small intestine. Possible causes include an ulcer, inflammation, a tear after forceful retching or enlarged veins. Oesophageal cancer and stomach cancer can also present with vomiting blood, but the appearance alone cannot identify the cause.

Arrange emergency medical assessment now rather than waiting for another episode. Do not drive yourself if you feel faint, weak or unwell; call emergency services or have another adult help. Avoid food and drink until a clinician advises otherwise, because a procedure may be needed. Take your medicines or a current list with you, especially noting blood thinners, anti-inflammatory pain medicines and any recent medicine changes. If practical, describe the colour and approximate amount to the clinical team, but do not delay leaving to photograph or collect the vomit.

Call emergency services immediately if vomiting blood occurs with collapse, confusion, severe weakness, difficulty breathing, chest or abdominal pain, cold clammy skin, a racing heartbeat or black tar-like stools. These signs can accompany substantial blood loss. A smaller visible amount still needs urgent assessment, because the amount seen does not reliably show whether bleeding is continuing internally.

Once immediate care is under way, ask where the bleeding is thought to have started, which tests can locate it and whether any medicine should be paused or changed. Tell the clinician about trouble swallowing, persistent indigestion, previous ulcers, liver disease, repeated retching, weight loss and earlier episodes of dark stools or bloody vomit. Those details help guide investigation; they do not establish a diagnosis by themselves.