What should you know about ulcers and vomiting blood?

An ulcer is a break in the lining of the stomach or nearby intestine. If it reaches a blood vessel, blood can enter the digestive tract. Vomiting may show fresh red blood or dark material resembling coffee grounds after blood has been partly digested.

Other explanations include inflammation, a tear after forceful retching, bleeding from the oesophagus, or a tumour. Vomiting blood does not by itself identify the cause or mean that cancer is present. A clinician may use blood tests and endoscopy to assess the bleeding and look for its source.

Contact urgent medical services and avoid driving yourself if you feel dizzy or weak. Keep a list of medicines, including aspirin and anticoagulants, and describe the colour and amount of vomited material. Do not self-treat with painkillers such as ibuprofen unless a clinician specifically advises it.

Get emergency help immediately for repeated vomiting of blood, fainting, severe abdominal pain, confusion, marked weakness, fast breathing, or black sticky stools. These signs can accompany substantial digestive bleeding. If symptoms are mild or have stopped, arrange same-day advice rather than waiting for a routine appointment.

Where is the bleeding most likely to be coming from? Could an ulcer be treated during an endoscopy? Should any of my medicines be changed? Do I need testing for the cause of the ulcer? What follow-up will confirm that the bleeding has settled?