Vomiting a large amount of blood: what to know

Blood brought up with vomit may be bright red, dark red, or look like coffee grounds. It can come from the oesophagus, stomach, or upper small intestine. Forceful vomiting can irritate or tear the lining, while a stomach or duodenal ulcer can bleed. Liver disease and medicines that affect clotting can make bleeding more serious. A small amount from the mouth or nose may also be swallowed and later vomited, but a large amount cannot be safely judged at home.

Call emergency services or go to the nearest emergency department now. Do not drive yourself if you feel faint. Sit upright or lie on your side if you may vomit again, and keep the airway clear. Do not eat, drink alcohol, or take aspirin or anti-inflammatory painkillers while waiting unless a clinician tells you to. Take your medicine list and, if possible, note the colour and approximate amount of blood.

Treat this as urgent immediately, especially with dizziness, fainting, confusion, pale clammy skin, rapid breathing, severe abdominal pain, black stools, or trouble staying awake. These signs can occur when blood loss affects circulation. Children, older adults, pregnant people, and anyone taking blood thinners need prompt professional help even when the amount seems smaller.

Ask what source of bleeding is suspected, whether an examination or camera test is needed, and which medicines should be paused or changed. Tell the clinician about ulcers, liver problems, alcohol use, recent retching, and every prescription, over-the-counter medicine, or supplement you take.