Headache and vomiting blood: what should you know?

Blood in vomit may look bright red, dark brown, or like coffee grounds. It can come from bleeding in the upper digestive tract, irritation after forceful vomiting, an ulcer, or swallowed blood from the mouth or nose. Headache may occur alongside dehydration, illness, faintness, or the underlying cause, but it does not explain away the bleeding.

Call emergency services or go to an emergency department now. Do not drive yourself if you feel faint, confused, weak, or unsteady. Sit upright or lie on your side if you may vomit again, and avoid food, alcohol, and non-prescribed medicines while waiting for medical advice. Keep or photograph any material vomited if this can be done safely, and bring a list of medicines, especially blood thinners or anti-inflammatory painkillers.

Treat the situation as an emergency if there is ongoing bleeding, black stool, severe abdominal pain, fainting, pale clammy skin, fast breathing, confusion, chest pain, or a sudden severe headache. Do not wait for symptoms to become worse or for a routine appointment.

Tell the clinician when the bleeding started, its colour and amount, how often you vomited, and whether you have black stool, abdominal pain, fever, dizziness, or a recent nosebleed. Include every medicine and supplement, plus alcohol use if relevant.