What should you know about seizure and vomiting blood?

Vomiting blood may look bright red, dark brown or like coffee grounds. It can come from bleeding in the upper digestive tract, including the food pipe or stomach. A seizure can cause loss of awareness, jerking, breathing difficulty or injury, and blood may also be present if the mouth or tongue was injured. The two symptoms may be related or may occur for separate reasons.

Oesophageal cancer and stomach cancer are possible causes of upper digestive bleeding, but many non-cancer causes exist. The symptoms alone cannot identify the cause. Doctors may need to protect breathing, check circulation, review medicines and investigate the digestive tract and nervous system.

Call emergency services immediately. Keep the person on their side after the seizure if they are breathing, clear nearby hazards and loosen tight clothing around the neck. Do not restrain them, put anything in their mouth, or give food, drink or tablets until they are fully alert.

Note when the seizure began, how long unusual movements lasted, the colour and amount of vomited blood, and any medicines or known medical conditions. If possible, keep a sample or photograph for clinicians without delaying transport. Do not drive the person yourself if they are confused, faint or still having seizures.

This situation already requires emergency care. It is especially urgent if the seizure lasts several minutes, repeats without recovery, breathing is abnormal, the person is injured or unconscious, vomit contains a large amount of blood, stools are black, or there is severe abdominal pain, weakness or fainting.

What is the likely source of the bleeding? Could a medicine or existing condition have contributed? Does the seizure need brain imaging or other testing? What warning signs should prompt another emergency call? Which medicines should be avoided until the cause is clear?