Hematemesis: What is it? Causes, Symptoms, Diagnosis, Complications and Treatment

It is the regurgitation of stomach contents mixed with blood or regurgitation of blood only.


Vomiting blood can be a frightening experience, but in some cases, it can be triggered by minor causes.

This includes swallowing blood from a wound in the mouth or a nosebleed. These minor causes probably do not cause any long-term damage.

Blood vomiting can also be caused by more severe conditions, such as internal injuries, organ bleeding, or organ rupture.

Regurgitated blood may appear brown, dark red, or bright red. Brown blood often resembles ground coffee when it vomits.

The color of the vomited blood can often tell the doctor the source and severity of the bleeding. For example, darker blood usually indicates that the bleeding comes from an upper gastrointestinal source, such as the stomach.

Darker blood usually represents a less rapid and constant source of bleeding. Bright red blood, on the other hand, often indicates an episode of acute hemorrhage that comes from the esophagus or stomach.


It can represent a source of faster bleeding. The color of the blood in the vomit may not always indicate the source and severity of the bleeding, but it should always prompt your doctor’s research.

If you vomit a large amount of blood, typically 500 cc or the size of a small cup, or if you vomit blood along with dizziness or changes in breathing, you should call your doctor immediately.

Why does vomiting occur in the blood?

There are many causes of vomiting blood. They vary in severity from minor to major and are usually the result of an injury, illness, or use of medications.

Blood vomiting can be caused by minor conditions such as:

  • Irritation of the esophagus.
  • Nasal hemorrhages.
  • Swallow blood
  • Tear in the esophagus due to chronic coughing or vomiting.
  • Swallow a strange object.

Other common causes of vomiting blood include:

  • Stomach ulcers
  • Side effects of aspirin.
  • Gastritis or inflammation of the stomach.
  • Non-steroidal anti-inflammatory side effects.
  • Pancreatitis.

The most severe causes of blood vomiting include:

  • Alcoholic hepatitis
  • Cirrhosis .
  • Esophagus cancer.
  • Erosion of the lining of the stomach.
  • Pancreatic cancer.

All instances of blood vomiting should be reported to your doctor.

Symptoms of Hematemesis

Several symptoms may be present, along with vomiting blood. These symptoms include, but are not limited to:

  • Nausea.
  • Abdominal discomfort
  • Abdominal pain.
  • Vomiting stomach content.
  • Vomiting blood can indicate a severe medical emergency.

Call your doctor if you experience any of these symptoms:

  • Dizziness.
  • Blurry vision.
  • Fast beats
  • Changes in breathing
  • Cold and damp skin.
  • Confusion.
  • Fainting.
  • Severe abdominal pain.
  • Vomiting blood after an injury.


Many potential health problems could cause you to vomit blood.

To determine your diagnosis, your doctor will start asking you questions about your symptoms and whether you were recently hurt or not.

Your doctor may order an imaging test to look inside your body.

Imaging scans reveal abnormalities in the body, such as organ rupture or abnormal growths.

  • CT scan.
  • Endoscopy is a device that allows your doctor to observe your stomach.
  • Ultrasound.
  • Bone scan.
  • MRI.

Your doctor may want to perform an upper endoscopy to look for blood in the stomach. This procedure is done while you are sedated.

Your doctor will place a small, flexible tube called an endoscope in your mouth and into your stomach and small intestine.

A fiber-optic camera in the tube allows your doctor to see the contents of your stomach and examine it internally to detect any source of bleeding.

Your doctor may order a blood test to check your complete blood count. This helps to evaluate the amount of blood lost.

A biopsy can also be done to determine if the source of bleeding represents an inflammatory, infectious or cancerous source.

Your doctor may order additional tests based on the result of your blood count.

Complications of vomiting blood

Asphyxia or aspiration is one of the main complications of vomiting blood. This can lead to the accumulation of blood in the lungs, which impairs their ability to breathe correctly.

Aspiration of blood in vomit, although rare, can be life-threatening if not treated immediately.

People who are at risk of aspiration of stomach contents include:

  • Older adults.
  • People with a history of alcohol abuse.
  • People with a history of stroke.
  • People with a history of disorders that affect their ability to swallow.
  • Depending on the cause, vomiting blood can cause additional health complications.

Anemia is another complication of excessive bleeding. It is a deficiency of healthy red blood cells. It occurs mainly when the blood loss is rapid and sudden.

However, people with slowly progressing diseases, such as gastritis or chronic NSAID use, may develop anemia for several weeks or months.

In this case, the anemia can remain without symptoms until its hemoglobin or blood count is very low.

Vomiting the blood caused by excessive bleeding can also cause a shock.

The following symptoms are indicators of shock:

  • Dizziness when standing up.
  • Rapid and superficial breathing.
  • Low production of urine.
  • Cold and pale skin.

If not treated immediately, the shock can cause a decrease in blood pressure, followed by coma and death. If you experience any symptoms of shock, ask someone to take you to the emergency room.

Treatment of Hematemesis

Depending on the amount of blood lost, you may need a blood transfusion.

A blood transfusion replaces your lost blood with donor blood. Blood passes into your vein through an intravenous line.

You may also need to be given intravenous fluid to rehydrate your body. Your doctor may give you medicine to stop vomiting or decrease stomach acid.

If you have an ulcer, your doctor will prescribe medications to treat it.

In certain more severe cases of upper gastrointestinal bleeding, a gastroenterologist can perform an upper endoscopy to diagnose and treat the source of the bleeding.

Surgery may be necessary in severe cases, such as people with stomach or intestine perforation of the stomach or intestine. Severe cases can also include a bleeding ulcer or internal injuries.

Some foods and beverages increase the likelihood of vomiting blood. These include but are not limited to highly acidic foods and alcoholic beverages.

If you consume these foods or drinks regularly, your doctor will create a special diet to decrease this risk.