Vomiting blood after heavy drinking: what to know

Blood may look bright red, dark brown, or like coffee grounds. Repeated retching can tear small vessels near the junction of the food pipe and stomach. Alcohol can also irritate the stomach lining, worsen inflammation, or contribute to bleeding from an ulcer. In some people, long-term liver disease raises pressure in veins around the food pipe, which can lead to serious bleeding. The symptom does not by itself identify the cause, and it does not mean cancer; clinicians may also consider conditions such as oesophageal cancer or stomach cancer when the history and examination suggest them.

Stop drinking alcohol and do not take aspirin or ibuprofen unless a clinician has specifically told you to use them. Do not drive yourself if you feel faint. Keep the container or note the colour and approximate amount of vomit, and list medicines, alcohol intake, liver problems, and previous ulcers for the medical team. Do not eat or drink until urgent medical advice tells you it is safe, especially if bleeding is continuing.

Call emergency services or go to an emergency department now if blood is still coming up, the vomit resembles coffee grounds, you feel faint or confused, your skin is cold or clammy, breathing is difficult, or you have severe abdominal or chest pain. Black, tar-like stools, a fast heartbeat, or marked weakness can also accompany significant bleeding. Even if the bleeding stops, arrange urgent assessment because the source can remain active.

Ask what source of bleeding is most likely, whether blood tests or a camera examination are needed, and which medicines or drinks to avoid. Ask how liver disease, ulcers, or forceful vomiting may have contributed and what warning signs should send you back for immediate care.