Vomiting blood: what to know and do now

Blood in vomit may look bright red, dark brown or like coffee grounds. It can come from the oesophagus, stomach or upper intestine, including irritation, ulcers, tears after forceful vomiting, medicines that affect clotting, or another illness. Vomiting blood is a presentation of oesophageal cancer in some people and a presentation of stomach cancer in some people, but the symptom alone cannot identify its cause.

Dizziness, weakness, pale or clammy skin, fast breathing, black stools or fainting can indicate significant blood loss. Do not wait for these additional signs before seeking help.

Call emergency services or go to an emergency department now, especially if blood is more than a small streak, keeps returning, or you feel unwell. Do not drive yourself. Sit upright or lie on your side if you feel faint, and take a list of medicines with you.

Do not eat or drink until a clinician advises you, and do not take aspirin, anti-inflammatory painkillers or other medicines unless an emergency clinician tells you to. Keep a sample or photograph only if it does not delay help.

Emergency help is needed for any vomiting of blood with faintness, confusion, severe abdominal or chest pain, black stools, breathing difficulty, or ongoing bleeding. People receiving cancer treatment should also tell the oncology team, but this must not delay emergency care.

Ask what source of bleeding was found, whether tests such as an endoscopy are needed, which medicines to stop or restart, and what symptoms should bring you back immediately.