What to do if you vomit blood

Blood in vomit may be bright red, dark, or grainy like coffee grounds. It can arise from irritation, an ulcer, a tear after repeated retching, swallowed blood, or a problem in the oesophagus or stomach. The symptom cannot identify the cause on its own.

A clinician may ask about swallowing difficulty, abdominal pain, black stools, alcohol use, previous digestive conditions, and medicines. Oesophageal cancer and stomach cancer can be considered during assessment, but many other explanations are possible.

Sit upright or lie on your side if you feel faint, and ask someone to stay with you. Avoid alcohol and do not take aspirin or anti-inflammatory painkillers unless a clinician directs you. Do not drive if dizzy. Write down the colour, approximate amount, number of episodes, preceding retching, and all medicines or supplements.

Call emergency services for continuing or heavy bleeding, fainting, confusion, cold clammy skin, fast breathing, severe pain, black stools, or difficulty staying awake. Emergency assessment is also needed if you cannot keep fluids down or swallowing becomes difficult.

Ask which tests may locate the bleeding, whether you should change any medicine, and what symptoms should trigger a return to emergency care. Explain whether this followed repeated vomiting, coughing, nosebleed, or a recent injury.