What should you know about vomiting phlegm and blood?

Mucus can come from the nose, throat, or airways and may be swallowed before vomiting. Repeated coughing or retching can irritate small blood vessels in the throat, producing streaks. Blood can also come from the food pipe or stomach. Bright red material suggests fresh bleeding, while dark material or coffee-ground-like particles may have stayed in the stomach longer. The presence of phlegm does not establish the cause, and vomiting blood is different from coughing blood.

Arrange urgent medical advice and avoid forcing yourself to vomit. Sit upright, or turn on your side if nausea or weakness is severe. Do not take aspirin or anti-inflammatory painkillers unless a clinician has told you to do so. Bring or photograph the material if safe, and record whether it followed coughing, retching, or a meal. Share details of nosebleeds, chest symptoms, abdominal pain, fever, and medicines with the clinician.

Seek emergency care immediately for repeated or increasing blood, difficulty breathing, chest pain, faintness, confusion, severe weakness, clammy skin, black stools, or intense abdominal pain. Coughing blood, rather than vomiting it, also needs urgent assessment because the source may be the lungs. Do not travel alone if you feel faint. Prompt assessment is especially important for anyone taking blood thinners or with liver disease.

Ask whether the blood appears to come from the throat, lungs, or digestive tract, whether tests are needed, and how to manage nausea safely. Mention recent infections, nosebleeds, forceful coughing, repeated vomiting, and all medicines.