What should you know about nose bleeding while vomiting?

Forceful retching can briefly increase pressure in delicate blood vessels in the nose. A dry nose, rubbing or irritation from vomit can make bleeding easier to start. Blood may trickle backward, be swallowed and later appear in vomit, so the timing and appearance matter. Vomiting may accompany gastroenteritis, food poisoning or migraine; less common serious illnesses can also cause vomiting with other warning symptoms. A nosebleed alone does not explain severe abdominal pain, fainting, confusion or repeated blood-stained vomit. Write down whether the blood began in a nostril, was swallowed, or appeared before any nosebleed.

Sit upright and lean forward. Pinch the soft part of the nose firmly and continuously for ten minutes, and spit out blood rather than swallowing it. When the bleeding settles, take small sips of fluid if vomiting has stopped. Rest and avoid nose blowing, picking and vigorous activity. Do not lie flat or tilt the head backward. If you cannot keep fluids down, a clinician can advise about rehydration and treatment for the cause of vomiting.

Seek urgent help for heavy or persistent bleeding, repeated vomiting of blood, black vomit or stools, faintness, confusion, breathing difficulty, severe abdominal pain, a stiff neck or signs of dehydration such as very little urine. Arrange a review for recurrent episodes, unexplained bruising or medicines that affect clotting. Bring details of recent illness, medicines, possible food exposure and the colour and amount of blood.

Could swallowed nose blood explain what I saw? Do I need assessment for dehydration or a digestive cause? Which symptoms should bring me back urgently?