COVID and Vomiting Blood

The medical term is haematemesis. Blood may be bright red, dark red or resemble coffee grounds. COVID may occur at the same time as digestive-tract bleeding, but the infection should not be assumed to explain it.

Vomited blood generally comes from the oesophagus, stomach or first part of the small intestine. Possible causes include an ulcer, inflammation, a tear after forceful retching, enlarged veins or another digestive disorder. Oesophageal cancer and stomach cancer can present with upper digestive bleeding, but vomiting blood has many other causes.

Swallowed blood from a nosebleed can later be vomited. Blood coughed from the airways may be frothy and mixed with mucus instead. A clinician can use the sequence of events, examination and tests to distinguish these sources.

Seek urgent medical care rather than waiting to see whether it happens again. Sit or lie on your side if you feel faint, avoid driving, and have someone stay with you. Follow emergency-service instructions about eating or drinking while help is arranged.

Tell the medical team about the amount and appearance of blood, black stools, abdominal pain, repeated retching and any dizziness. Bring or list all medicines, especially anticoagulants, antiplatelet medicines and anti-inflammatory painkillers. Mention a positive COVID test or respiratory symptoms so staff can use suitable infection precautions without delaying bleeding assessment.

Call emergency services now for any substantial or continuing blood loss, or if vomiting blood occurs with fainting, confusion, clammy skin, severe weakness, rapid breathing, chest pain, severe abdominal pain or black tar-like stools. These signs may accompany significant internal bleeding.

Breathing difficulty, blue lips or inability to stay awake also require immediate help, whether related to COVID, blood loss or another problem. Even a small amount merits urgent clinical advice because the colour and volume seen at home do not reliably show how serious the source is.

Ask what source of bleeding is suspected, whether your blood count or circulation has been affected, and whether an endoscopy or other investigation is needed. Clarify which medicines to pause or continue only after the treating clinician has reviewed them, and ask which symptoms should prompt an immediate return after discharge.