Vomiting blood

Category: Digestive & Abdomen · All digestive symptoms

What it can feel like

Vomiting blood — fresh red blood, or dark material like coffee grounds — means bleeding somewhere in the gullet, stomach or upper bowel. It is always an emergency symptom: call for urgent help or go to emergency care immediately, even if the amount seems small.

Possible causes

A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.

Common causes

Vomiting blood can be associated with a tear in the gullet lining after forceful retching, with inflamed stomach lining from alcohol or anti-inflammatory painkillers, and with stomach or duodenal ulcers.

Other possible causes

It can also be associated with enlarged veins in the gullet in liver disease, and with tumours of the stomach or gullet. Blood thinners and alcohol increase the risk and the severity of bleeding.

Red flags — when to seek help promptly

Any vomiting of blood — treat as an emergency
Vomiting blood with dizziness, fainting, sweating or a racing pulse
Vomiting blood with black stools or severe abdominal pain
Vomiting blood in someone with liver disease or who takes blood thinners

What a clinician may do

Emergency teams will check circulation, set up a drip, take blood tests and cross-match blood. Once stable, a camera examination of the stomach (gastroscopy) usually identifies and often treats the bleeding point.

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Frequently asked questions

What should I do while waiting for help?

Stop eating and drinking, sit or lie somewhere safe, and keep any vomit to show the team if you can. Do not drive yourself. If you feel faint, lie down and raise your legs while someone stays with you.

What are 'coffee grounds' in vomit?

Blood that has sat in the stomach is partly digested by acid and turns dark and grainy, like coffee grounds. It still means bleeding in the upper gut and needs the same emergency assessment as fresh blood.

Related symptoms — Digestive & Abdomen

Abdominal pain Black stools Bloating Blood in the stool Change in bowel habit Constipation

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Please note: This page is educational information about a symptom. A symptom alone cannot diagnose any condition, and the causes listed here are possibilities, not a diagnosis. If you are worried about a symptom — especially one that is new, severe, getting worse or not going away — please see your own clinician, who can examine you and arrange tests. In an emergency, call your local emergency number.