What should you know about trace of blood in vomit?

Blood may look bright red, dark brown, or like coffee grounds. A small streak can follow forceful vomiting, irritation of the throat, a tear near the lower oesophagus, a stomach ulcer, or medicines that affect the stomach or clotting. Swallowed blood from the nose or mouth can also appear in vomit.

Oesophageal cancer and stomach cancer can present with vomiting blood, but this symptom has many non-cancer causes. The appearance, amount, repeated episodes, abdominal pain, black stools, medicines, and other symptoms help clinicians decide what tests are needed.

Arrange prompt medical assessment and describe the colour, amount, timing, and whether vomiting was forceful. Mention black or tar-like stools, dizziness, abdominal pain, alcohol use, ulcers, liver disease, pregnancy, and every medicine or supplement, especially blood thinners or anti-inflammatory painkillers.

Do not take extra anti-inflammatory painkillers or drink alcohol while waiting for advice. If the episode follows a known nosebleed, still tell a clinician when blood was swallowed. Keep a record if it happens again.

Seek emergency care for more than a small streak, repeated vomiting of blood, coffee-ground vomit, black stools, fainting, confusion, cold clammy skin, fast breathing, severe weakness, or severe chest or abdominal pain. Do not drive yourself if you feel faint; ask someone to stay with you while emergency help is arranged.

Where might the blood have come from? Do I need blood tests, imaging, or an endoscopy? Could any of my medicines be contributing? What signs should make me return immediately if the bleeding stops for now?