Black Vomiting: Symptoms, Causes, Diagnosis, Related Diseases and Treatment

Patients who vomit dark brown or black blood, bright red blood, or blood that looks like ground coffee should see a doctor immediately.

When the vomit contains bile and other intestinal contents, it is a bright yellow to dark green and bitter.

The usual vomiting of the stomach is pale brown and sour.

Bile is a digestive juice produced in the liver, stored in the gallbladder and after meals, and administered in the first part of the small intestine (duodenum), where it helps to digest fats.

Certain foods or spices, such as leafy green vegetables, fruit juices, carrots, curries, turmeric, and medicinal syrups, can also color yellow or green vomit.

Black vomit is usually caused by bleeding in the upper gastrointestinal tract.

Bleeding is a sign of an underlying medical problem.


Occasionally, black vomit may be caused by something a patient has eaten, such as a patient who eats dark food such as a chocolate cake and then becomes ill.

However, if there is no dietary explanation, the dark vomit may signify a medical emergency.

When people experience bleeding in the upper gastrointestinal tract, blood can enter the stomach, and stomach enzymes break it down, turning it dark brown or black, and this causes black vomit.

Bleeding can include prolonged vomiting that leads to tears in the esophagus, tumors, kidney disease, alcoholism, bleeding ulcers, internal trauma, and hemorrhagic disorders such as yellow fever.

Certain medications can also contribute to bleeding, especially when combined with other drugs or used with herbal supplements.

The vomit of ground coffee, named for its appearance, occurs due to coagulated blood in the vomit.

Vomiting blood is also known as hematemesis or emesis of coffee land.

The color of the vomited blood varies according to the time the blood was in the gastrointestinal system.

This is a severe condition and requires immediate medical attention.

You should write down the time and amount you vomited and anything that may have caused the vomit.

If possible, you should bring a sample of the vomit to the doctor for further testing.

Symptoms that occur together with black vomiting

When this type of vomiting occurs, likely, there are also specific symptoms such as:

  • The skin becomes unusually pale.
  • Stunning appears.
  • Fainting may occur.
  • Dizziness, excessive diarrhea, and abnormal sweating may occur.
  • You can feel pain in the chest.
  • Red and shiny blood or large clots may appear in the vomit.
  • The presence of severe abdominal pain.
  • Feeling weak, disoriented, and having a pale appearance are important causes of concern, as they may indicate that the patient is losing blood internally.


The color black in the vomit can be attributed to the food consumed just before the vomit episode or to the presence of blood in the gastrointestinal system.

While the cause of the first factor can be verified, several factors are associated with bleeding in the gastrointestinal system.

Thus the black spots in the vomit indicate the presence of blood clots in it.

Many factors can contribute to blood in the vomit; the black spots in the vomit indicate a medical emergency.

Certain conditions cause bleeding in the upper gastrointestinal tract; during the development of this disease process, the blood in the stomach is mixed with hydrochloric acid from gastric juices and food debris.

During this time, it accumulates in the stomach cavity, and due to specific chemical reactions, it gradually changes from bright red to dark brown or black.

When the amount of blood in the stomach becomes too high, the patient triggers a gag reflex and vomits the blood together with the rest of the food ordered in the stomach producing a vomit with brown spots like a coffee eraser.

It is broken down by the various enzymes and acids present in the stomach.

This degeneration of the blood causes its color to change from red to dark brown or black. It is always recommended to verify the condition and check for internal gastrointestinal bleeding.

Some of the possible causes of black vomiting include:

  • A tear or damage to the esophageal lining or the stomach lining.
  • The presence of polyps in the upper part of the gastrointestinal system.
  • Cancer of the esophagus, pancreas, or stomach.
  • Excessive consumption of alcohol can also cause internal bleeding.
  • Peptic or gastric ulcer is also associated with black substances in vomit.
  • Certain medications can also increase the risk of internal bleeding and give rise to black substances in the vomit.
  • Internal traumas can also cause black spots of vomiting.
  • Drug overdose.
  • Esophageal varices are related to diseases such as cirrhosis or gastritis.
  • Problems related to diseases like viral hepatitis, autoimmune disorders, or fatty liver disease.
  • Diseases such as infection with the Ebola virus, hemophilia B, or yellow fever.

Diagnosis of the cause of black vomit

Black vomit is often an indicator of gastrointestinal bleeding.

The doctor will elaborate on the medical history, the symptoms, and other health conditions and review the patient’s medications.

Then perform a physical examination and order the tests to determine what is causing the bleeding, such as:

  • X-rays
  • The initial blood tests.
  • The blood test is hidden in the stomach.
  • A high digestive endoscopy is a procedure where the doctor inserts a small flexible endoscope with a camera into the esophagus.
  • A barium X-ray study, a special x-ray that uses barium as a contrast medium, will help the doctor identify problems in your gastrointestinal tract.
  • Liver function studies through blood tests can help the doctor identify any disease or damage present in the liver.
  • A fecal occult blood laboratory test can detect blood in the stool.
  • During a flexible sigmoidoscopy or colonoscopy, the doctor inserts a tiny endoscope with a camera through the anus to check the colon and rectum.

The doctor will make a differential diagnosis based on these tests and begin a treatment plan to address the underlying condition that causes the black vomit.

First aid

First, the patient should be placed on a straight and stable surface; great care must be taken so that the patient’s body does not bend at the waist and the clothing does not press on the abdomen.

The patient should be placed on his side so that if he has a new impulse when vomiting, he will not have to move, and he will not choke on his vomit.

In no case should we try to facilitate the patient’s condition by gastric lavage or the application of enemas?

Oral administration of drugs is not recommended since they could worsen the patient’s condition or be useless. They could not be absorbed if a new vomit was presented after administration.

The patient’s condition can be alleviated with cold compresses on the abdomen.

If a person presents with black vomits, solid or liquid foods should not be administered.

Even running water can increase internal bleeding.

Carbonated beverages can be fatal because they can cause an increase in bleeding and heat the affected area.

In any case, the presence of black vomit can not be ignored, and self-medicated can lead the patient to severe clinical pictures and even death.

An internal hemorrhage is a pathology too severe, which often requires surgical intervention.


Treatments for black vomit are aimed at the underlying disease and may include surgical interventions, the administration of medications, and even diets.

The treatment will also depend on the cause of the bleeding, the amount of blood that the patient has lost, and the general condition that the patient presents.

Some people have a higher risk of bleeding in the upper gastrointestinal tract and should be aware of the signs of a developing hemorrhage and follow the instructions they may have received from their doctors to the letter.

Leaving untreated bleeding can have severe consequences for a patient, including developing a life-threatening medical emergency.

Patients should also be aware that if bleeding has occurred in the past, a later episode may have a different cause, and a different approach to treatment may be required.

Related diseases

The upper part of the gastrointestinal tract comprises the lower segment of the esophagus, the stomach, and the upper segment of the small intestine called the duodenum.

When mixed with stomach acid, the appearance of blood in this area makes the vomit turn dark or black.

This indicates where a part of the tract is experiencing bleeding.

The differential diagnosis of black vomit is then a gastrointestinal hemorrhage.

Peptic ulcers:

It is known as peptic ulcer irritations or fissures that occur in the inner lining of the stomach and small intestine.

Many causes can cause stomach ulcers, but the most common cause is overuse of medications, especially anti-inflammatory drugs such as ibuprofen or aspirin.

When the perforation of the ulcer or the exacerbation of the disease occurs, there may be an outflow of blood from the blood vessels that are being affected by erosion or altered by the pathological process.

In this case, this blood enters the lumen of the digestive organs, which leads to the appearance of black vomiting.

Irritations in the stomach, esophagus, or liver:

A general irritation in the gastrointestinal tract can cause black vomit.

Constant acid reflux and a poor diet are the two most significant warning signs of this condition.

However, minor irritation is widespread in people if it is not constant.

Although this is a cause that is less severe ulcer, anyone who experiences this irritation will require medical treatment with medications for irritation accompanied by a change in diet.

Other causes can also be included, such as the excessive use of alcohol and tobacco and the presence of persistent vomiting.

The stomach lining also becomes irritated and erodes due to bacterial infections.

Liver diseases:

The vomit of greenish-black color can indicate the presence of bile and show some type of disease present in the liver, such as viral hepatitis, cirrhosis, autoimmune diseases, or fatty liver disease.

Yellow fever:

Yellow fever, in sporadic cases, presents as a symptom of black vomit, but this can be an indicator of the viral infection that transmits the bite of the mosquito and is common in countries such as South America and Africa.

This type of infection can cause internal bleeding and organic failure.

The polyps :

A polyp is a growth in normal tissue; polyps usually do not hurt unless they are significant.

If the polyp breaks off or breaks slightly, it can bleed, and that can cause black vomit.

Esophagus, pancreas, or stomach cancer:

People with cancer may present black vomit, which often occurs in cancer patients when the metastasis phase affects the digestive organs.

In cancer, the color black in the vomit may indicate that the malignant tissue tissue tissue is damaged.

This bleeding can occur as a result of pathological processes in the body and as a side effect of the treatment of chemotherapy.

The internal traumas:

Internal traumas resulting from physical impacts can also cause black spots in the vomit if internal bleeding occurs.

Tear or damage to the esophageal or stomach lining:

A tear or damage to the esophagus or stomach can occur when these organs come into contact with a foreign body, which enters the gastrointestinal tract by accidental ingestion and damages the stomach lining.

These can be hazardous cutting objects, such as bone fragments with jagged or sharp edges.