What should you know about vomiting dark blood like coffee grounds?

Blood can turn dark and grainy after contact with stomach acid. Causes can include irritation or an ulcer in the stomach or upper bowel, bleeding after forceful vomiting, or bleeding from enlarged veins in the food pipe. The appearance does not show how much blood has been lost. Abdominal pain, black stools, weakness or dizziness make the concern greater, but serious bleeding can occur without pain.

Treat coffee-ground vomit as an emergency. Contact emergency services or go to an emergency department now, and do not drive yourself if faint, weak or dizzy. Keep a sample or photograph if safe, and take a list of medicines, especially blood thinners or anti-inflammatory painkillers. Do not eat or drink large amounts while waiting for medical instructions.

Call emergency services immediately for continued vomiting blood, bright-red blood, black tarry stools, fainting, confusion, rapid breathing, cold clammy skin, severe abdominal pain or chest pain. Even if the vomiting stops and you feel better, same-day emergency assessment is still needed because bleeding can recur or continue unnoticed.

Ask where the bleeding may have started, which medicines to pause or avoid, whether tests or observation are needed, and which changes require an immediate return.