Vomiting blood (hematemesis) refers to significant amounts of blood in your vomit. Small streaks or flecks of blood in material you spit up may come from the teeth, mouth or throat and isn’t usually considered vomiting blood. Blood in vomit may be bright red, or it may appear black or dark brown like coffee grounds.
Swallowed blood, as from a nosebleed or forceful coughing, may cause bloody vomit, but truly vomiting blood usually represents something more serious and requires immediate medical attention. Bleeding in your upper gastrointestinal tract (mouth, esophagus, stomach and upper small intestine) from peptic ulcers or torn blood vessels is a common cause of vomiting blood.
Call 911 or go to the nearest hospital if vomiting blood causes dizziness after standing, rapid, shallow breathing or other signs of shock.
Causes
- Acute liver failure
- Alcohol use disorder
- Aspirin
- Benign tumors of the stomach or esophagus
- Cirrhosis (scarring of the liver)
- Defects in gastrointestinal tract blood vessels
- Dieulafoy’s lesion (an artery that protrudes through the stomach wall)
- Duodenitis (inflammation in the first part of the small intestine)
- Esophageal cancer
- Esophageal varices (enlarged veins in the esophagus)
- Esophagitis (inflammation of the esophagus)
- Gastric erosions (breakdown of tissue lining the stomach)
- Gastric varices (enlarged veins in the stomach)
- Gastritis (inflammation of the stomach)
- Mallory-Weiss tear (tear in the esophagus associated with pressure caused by vomiting or coughing)
- Nonsteroidal anti-inflammatory drugs
- Pancreatic cancer
- Pancreatitis (pancreas inflammation)
- Peptic ulcer
- Portal hypertension (high blood pressure in the portal vein)
- Prolonged or vigorous vomiting
- Stomach cancer
In infants and young children, vomiting blood may also result from:
- Birth defects
- Blood clotting disorders
- Milk allergy
- Swallowed blood, such as from the nose
- Swallowed object
- Vitamin K deficiency
When to see a doctor
Call for emergency medical assistance if vomiting blood causes signs and symptoms of shock, such as:
- Rapid, shallow breathing
- Dizziness or lightheadedness after standing up
- Blurred vision
- Fainting
- Confusion
- Nausea
- Cold, clammy, pale skin
- Low urine output
Ask someone to drive you to urgent care or the emergency room if you notice blood in your vomit or begin vomiting blood. It’s important to quickly identify the underlying cause of the bleeding and prevent more-severe blood loss and other complications, including death.
