Liver and Vomiting Blood: What You Should Know

Blood in vomit may look bright red, dark brown, or like coffee grounds. The bleeding can arise from the food pipe, stomach, or the first part of the small intestine. Liver disease may cause increased pressure in veins carrying blood through the liver. Enlarged veins in the food pipe or stomach can then bleed, sometimes suddenly and heavily.

Other causes include irritation or a tear after repeated retching, stomach ulcers, inflammation, and medicines that affect bleeding. Vomiting blood does not by itself identify the cause, and it does not mean that cancer is present. Conditions such as [oesophageal cancer](/conditions/oesophageal-cancer/) and [stomach cancer](/conditions/stomach-cancer/) can cause digestive bleeding, but many non-cancerous conditions can do so as well.

Call emergency services or go to an emergency department. Do not drive yourself if you feel faint, confused, weak, or short of breath. Sit upright or lie on your side while waiting, and keep someone with you if possible.

Do not eat or drink until a clinician advises you, and do not take aspirin, ibuprofen, or another medicine that can worsen bleeding unless a clinician has specifically told you to take it. Bring a list of your medicines, any known liver diagnosis, and details about the colour and amount of blood. If possible, note whether black stools, abdominal pain, or repeated vomiting occurred.

Any vomiting of blood warrants urgent medical assessment. Treat it as an emergency if bleeding continues or returns, the vomit contains clots, stools are black and sticky, or you have dizziness, fainting, rapid breathing, a racing heartbeat, pale or clammy skin, confusion, or severe abdominal pain. These signs can occur when blood loss is affecting circulation.

People with known liver disease should not wait for a routine appointment, even if the bleeding seems to have stopped. A hospital team may check circulation and blood counts, give fluids or blood products when needed, and use a camera test to locate and control the bleeding. Further tests can identify the underlying liver or digestive condition.

Ask what the likely bleeding site is and whether increased pressure related to liver disease may be involved. Ask which medicines should be stopped or changed, whether you need an endoscopy or liver tests, and how to recognise another bleed. Also ask how alcohol, pain medicines, and any blood-thinning treatment could affect your risk.