What should you know about flecks of blood in vomit?

Bright-red streaks may come from irritation in the throat or food pipe after forceful retching. Dark, brown or coffee-ground material can indicate blood that has remained in the stomach. Causes include inflammation, an ulcer, medicines that irritate the stomach, or a tear after repeated vomiting. Cancers of the oesophagus or stomach are less common possibilities, and blood in vomit does not by itself identify the cause.

Arrange same-day medical advice even if the flecks have stopped. Note the colour and amount, how many times you vomited, and whether you have taken anti-inflammatory medicines or blood thinners. Avoid alcohol and further doses of non-prescribed anti-inflammatory painkillers until assessed. Do not drive yourself if you feel faint, and keep a photo or sample available if a clinician asks about the appearance.

Call emergency services now for ongoing or heavy bleeding, black stools, fainting, confusion, fast breathing, severe abdominal or chest pain, or cold clammy skin. Urgent assessment is also needed if you cannot keep fluids down or feel unusually weak. People receiving cancer treatment should contact their cancer team as well as seeking emergency help when these signs occur.

Ask what tests may locate the bleeding, whether any medicine should be paused, and how to manage nausea without irritating the stomach. Mention swallowing difficulty, weight change, persistent indigestion or previous ulcers.