What should you know about dark blood in vomit?

Blood can turn brown, black or grainy after contact with stomach acid. The bleeding may come from the oesophagus, stomach or the first part of the small bowel. You cannot judge the seriousness from colour or amount alone, and bleeding may continue internally after vomiting stops.

Upper digestive bleeding can arise from an ulcer, inflammation, a tear after forceful vomiting, enlarged veins or medicines that increase bleeding. Swallowed blood from a nose or mouth bleed can sometimes appear in vomit as well. Medical assessment is needed to locate the source and check its effect on circulation.

Stomach cancer and oesophageal cancer can present with vomiting blood, but this symptom has several other causes. The urgent action is based on possible bleeding, not on an assumption about cancer. Tests may include blood checks and an examination of the upper digestive tract once the person is stabilised.

Contact emergency services or go to an emergency department now, following local instructions. Do not drive yourself if you feel faint, weak or unwell. If possible, have someone stay with you and bring your medicines or a current medicine list, especially anticoagulants, aspirin and anti-inflammatory pain medicines.

Do not delay care to monitor another episode or try to treat the bleeding with food, antacids or home remedies. Avoid eating or drinking until the emergency team advises you, because a procedure may be needed.

Call emergency services immediately if dark or bloody vomit occurs with fainting, dizziness, confusion, rapid or difficult breathing, cold clammy skin, severe chest or abdominal pain, a racing heartbeat, black tar-like stool or collapse. These can accompany substantial blood loss or another serious problem.

Even without those additional signs, any suspected blood in vomit still warrants urgent medical help. A previous ulcer, liver condition, digestive cancer or use of blood-thinning medicine makes it particularly important to tell the emergency team your history promptly.

Once urgent care is underway, ask where the bleeding is thought to have started, whether any medicine should be paused or changed, what tests are planned, and which signs mean you should return after discharge. Do not stop a prescribed anticoagulant on your own unless the treating clinician directs you.