Vomiting blood is the forcing of the stomach contents up through the esophagus (the swallowing tube) and out of the mouth, in which the vomit contains blood.
When blood is vomited, it may appear either a bright red or dark red color. Only blood may be seen, or the blood may come up mixed with food.
It can sometimes be difficult to tell the difference between vomiting blood and coughing up blood (from the lung) or a nosebleed.
Conditions that cause vomiting blood can also cause blood in the stool.
The upper GI tract includes the stomach, mouth, throat, esophagus, and the first part of the small intestine. Blood that is vomited may come from any one of these places.
For example, vomiting that is very forceful or continues for a very long time may cause a tear in the small blood vessels of the throat or the esophagus, producing streaks of blood in the vomit.
Swollen veins in the walls of the lower part of the esophagus, and sometimes the stomach, may begin to bleed. These veins are present in people with severe liver damage.
Other causes may include:
Although not all situations are the result of a major medical problem, this is difficult to know without a medical evaluation. Seek immediate medical attention.
Call your doctor or go to the emergency room if vomiting of blood occurs -- this requires immediate medical evaluation.
The doctor will examine you and ask questions such as:
Tests that may be done include:
If you have vomited a lot of blood, you may need emergency treatment, which may include:
Hematemesis; Blood in the vomit
Overton DT. Gastrointestinal bleeding. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. Columbus, OH: McGraw-Hill; 2006:chap 74.
Henneman PL. Gastrointestinal bleeding. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 22.
Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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