Vomiting a Lot of Blood: What to Know

Blood in vomit can come from the throat, oesophagus, stomach, or the first part of the small intestine. A tear after repeated retching, an ulcer, inflammation, or enlarged veins can cause bleeding. Bright-red blood may be fresh; dark material resembling coffee grounds can be partly digested blood. Appearance cannot show how much blood has been lost.

Severe bleeding can reduce circulation and oxygen delivery. Warning symptoms include dizziness, fainting, pale or clammy skin, a racing heartbeat, confusion, shortness of breath, and marked weakness. Vomiting and abdominal conditions can have different causes, so do not try to identify the source before getting help. General information about [Vomiting](/symptoms/vomiting/) may help after urgent care is arranged.

Call emergency services now. Do not drive yourself. Sit upright or lie on your side if you feel faint, and have someone stay with you. Keep the container or a photograph of the vomit if this can be done without delaying help.

Do not eat, drink, smoke, or take aspirin, ibuprofen, or other medicines unless emergency clinicians tell you to do so. Tell the responders about blood thinners, stomach medicines, alcohol use, liver disease, previous ulcers, and any recent forceful vomiting. Bring a list of medicines if it is readily available.

Emergency care is needed immediately for a large amount of blood, repeated bloody vomiting, coffee-ground material, black stools, fainting, confusion, severe weakness, chest pain, or severe abdominal pain. These signs can occur with or without pain, so feeling relatively calm does not make heavy bleeding safe to watch at home.

If the person becomes unresponsive or is not breathing normally, call emergency services and follow the dispatcher’s instructions. Do not leave them alone or give anything by mouth while waiting.

After emergency treatment, ask where the bleeding came from, whether further tests or monitoring are needed, which medicines should be stopped or continued, and which symptoms require a return to hospital.