What should you know about cough and vomiting blood?

Blood brought up during coughing usually comes from the airways, whereas blood expelled with nausea or retching usually comes from the upper digestive tract. It can be hard to tell the difference, and either type of active bleeding warrants prompt professional assessment.

Vomited blood may look bright red, dark red or like damp coffee grounds. It may occur with upper abdominal discomfort, nausea, black sticky stools or light-headedness. Coughing blood is often mixed with mucus and follows a cough, sometimes with chest discomfort or breathlessness.

Possible digestive sources include irritation, an ulcer or a tear after forceful retching. Oesophageal cancer and stomach cancer can present with bleeding, often with other features such as swallowing difficulty, persistent upper abdominal symptoms, reduced appetite or unexplained weight loss. The symptom pattern does not determine the diagnosis by itself.

Seek urgent medical advice now rather than waiting for another episode. If emergency help is on the way, sit or lie somewhere safe and have another person stay with you. Do not drive yourself if you feel faint, weak, confused or short of breath.

Tell the clinician whether nausea, retching or coughing came first, what the blood looked like and whether stools have turned black. Provide your medicine list, especially blood-thinning medicines and anti-inflammatory pain relievers, and mention liver disease, ulcers, recent procedures or cancer treatment.

Call emergency services if bleeding is continuing or substantial, or if you have fainting, severe dizziness, confusion, cold clammy skin, rapid breathing, severe chest or abdominal pain, or difficulty breathing. These can be signs of significant blood loss or another serious problem.

Even a small amount of vomited blood needs urgent assessment on the same day. Dark coffee-ground material or black sticky stool can represent altered blood and should not be dismissed because it is not bright red.

Once you are stable, ask what source of bleeding is suspected, which tests will locate it, whether any medicines should be paused or changed, and what signs should bring you back immediately. Confirm how and when you will receive follow-up results.