What should you know about vomiting pure blood?

Treat this as an emergency, even if the vomiting has stopped or the amount seems small. Fresh blood may be bright red; material that looks like coffee grounds can also represent digested blood.

Blood in vomit can come from the oesophagus, stomach, or first part of the small bowel. A tear after forceful retching, irritation or an ulcer, swollen veins in the oesophagus, and bleeding linked to medicines are possible causes. Blood swallowed from a nosebleed or mouth injury can occasionally be vomited, but it still deserves assessment when you cannot clearly identify the source.

Call emergency services or go to an emergency department now. Do not drive yourself if you feel weak, dizzy, faint, confused, or short of breath. If possible, have someone stay with you and bring a list of your medicines, especially blood thinners, aspirin, anti-inflammatory pain medicines, or supplements.

Avoid alcohol and do not take aspirin or ibuprofen for pain unless a clinician who knows your situation tells you to. Do not try to make yourself vomit. If you are actively vomiting or drowsy, sit upright or lie on your side while waiting for help to reduce the risk of choking.

Emergency assessment is particularly urgent with repeated vomiting of blood, black sticky stools, severe stomach or chest pain, a fast heartbeat, clammy skin, fainting, or unusual sleepiness. These signs can occur when blood loss or the underlying illness is affecting the body more widely. Children, older adults, people with liver disease, and anyone taking medicines that affect bleeding should not wait for symptoms to settle.

Ask what source of bleeding is suspected, whether you need blood tests or a camera examination of the upper digestive tract, and which medicines to stop, continue, or avoid. Also ask what return symptoms should prompt an immediate visit after you leave care, such as another episode of bleeding, black stools, dizziness, or worsening pain.