Coagulated blood in vomit

Fresh blood may look bright red, while blood exposed to stomach acid can become dark and granular. Both appearances can represent haematemesis. Do not wait for another episode before seeking help.

Bleeding can arise from the oesophagus, stomach or first part of the small intestine. Possible causes include an ulcer, inflammation, a tear after forceful vomiting, enlarged veins, medicines that promote bleeding and, less commonly, a growth in the upper digestive tract.

Oesophageal cancer or stomach cancer can present with bleeding, but vomited blood does not by itself identify the cause. The direction of assessment is to locate and control the bleed first, then determine why it happened.

Arrange emergency medical assessment now. If possible, note the colour and approximate amount, whether there were clots or coffee-ground particles, and whether the stool is black or bloody. Bring a current medicine list, particularly blood thinners, anti-inflammatory painkillers and cancer treatments.

Avoid driving yourself if you feel weak, faint, confused or short of breath. Do not take food, drink or additional medicine while awaiting advice from emergency clinicians, because a procedure may be needed. Never stop a prescribed blood thinner unless the treating clinician directs you to do so.

Call emergency services immediately if vomiting blood occurs with fainting, dizziness, clammy or pale skin, confusion, rapid breathing, severe abdominal or chest pain, black tar-like stool, ongoing vomiting or a large amount of blood. These can accompany significant blood loss or another serious problem.

People receiving cancer treatment may also have low platelets, irritated digestive tissue or infection, which can complicate bleeding. Use the oncology service's emergency contact as instructed, but do not delay emergency care while waiting for a routine callback.

Report when the vomiting started, earlier retching, abdominal pain, swallowing difficulty, recent black stool, alcohol use, liver disease and every medicine taken. Ask what is being done to find the bleeding site, whether an endoscopy is needed, how medicines should be managed and which signs require returning after discharge.