GERD and vomiting blood

GERD can irritate the oesophagus, but blood in vomit can also come from a tear after forceful vomiting, an ulcer, or bleeding elsewhere in the stomach or upper digestive tract. Blood may look bright red, dark, or like coffee grounds. Severe reflux does not explain away this sign, and the amount you see does not reliably show how serious the bleeding is. A clinician may ask about medicines, alcohol, previous ulcers, black stools, dizziness and abdominal pain before arranging tests.

Stop eating and drinking until urgent medical advice tells you otherwise, and do not take aspirin or anti-inflammatory pain medicines unless a clinician has specifically advised them. Do not drive if you feel faint. Take a list of medicines and describe the colour and timing of the vomit. Assessment may include blood tests and a camera examination of the upper digestive tract. Cancer of the oesophagus or stomach can sometimes bleed, but many non-cancer causes are also possible.

Call emergency services or go to an emergency department now if you vomit blood, pass black tar-like stool, feel faint or confused, have cold clammy skin, severe pain, fast breathing, or cannot keep fluids down. Do not wait for a routine reflux appointment. Even a single episode deserves prompt assessment because bleeding can continue after the vomiting stops.

Could a medicine or ulcer be causing the bleeding? Do I need an endoscopy? Which reflux medicines should I pause or continue? What symptoms should bring me back urgently?