Vomiting Blood: What Can Cause It?

There are many reasons for vomiting blood. If this happens, be on the lookout for other symptoms, as it may require immediate attention.

Reviewed and approved by the doctor Diego Pereira.

Written by Edith Sánchez

Last update: 28 October, 2023

Vomiting blood makes a big impression, but it isn’t always a sign of something serious. This symptom, whose technical name is hematemesis, is described as the regurgitation of blood, sometimes mixed with the contents of the stomach.

In the most severe cases, vomiting blood is a sign of bleeding in the upper gastrointestinal tract. This includes the mouth, esophagus, stomach, and upper small intestine. However, sometimes the symptom appears because blood was swallowed after a nosebleed or as a result of a violent cough, among others.

Vomiting blood is considered an alarm signal, particularly when the person vomits a lot of blood, and if it’s accompanied by dizziness when standing up or breathing difficulties. In these cases, it would be a medical emergency.

What causes hematemesis?

There are many reasons for vomiting blood. In fact, sometimes the blood doesn’t actually come from the stomach, but from the teeth, throat, or mouth. Also, when blood is swallowed for some reason, it usually regurgitates.

This symptom also appears when foreign objects are swallowed, or as a result of irritation or a tear in the esophagus. This can occur after a violent coughing spell or chronic vomiting. Other possible causes include the following:

• An ulcer in the esophagus, stomach, or first part of the small intestine
• Inflammation of the stomach lining, or gastritis
• Clotting disorders
• Pancreatitis
• Side effects of aspirin or non-steroidal anti-inflammatory drugs
• Cirrhosis or alcoholic hepatitis
• Tumors in the mouth, throat, esophagus, or stomach
• Cancer of the esophagus or pancreas

What other symptoms may occur?

The vomiting of blood is usually accompanied by other symptoms such as nausea, malaise, and abdominal pain. Simultaneous vomiting of stomach contents is also possible.

Sometimes other symptoms appear that are considered indicators of a medical emergency. Among them, the U.S. National Library of Medicine notes the following:

• Dizziness
• Confusion
• Fainting
• Severe abdominal pain
• Blurred vision
• Increased heart rate
• Cold or clammy skin
• Changes in breathing
• Vomiting blood after an injury

How is it diagnosed?

Since vomiting of blood can occur for many reasons, diagnosis may require several tests. Most commonly, it begins with a physical examination and an interview with the patient.

If the physician considers it appropriate, he/she will ask for one or more imaging scans to observe the condition of the digestive tract. In this way, tests such as the following are performed:

• Endoscopy
• X-ray
• Ultrasound
• Magnetic resonance imaging
• Computerized tomography

Also, it’s common for a blood test, or complete blood count, to be performed, as this helps to establish how much blood has been lost. Based on this, other tests may be carried out. In some cases, a biopsy is performed.

Vomiting blood: what treatments are there?

If the vomiting has been very copious, a blood transfusion and the administration of fluids to rehydrate the body may be required. Both procedures are carried out intravenously.

Most commonly, the doctor will prescribe some drugs to stop vomiting, decrease stomach acid or treat an ulcer, if present. If a more serious condition is suspected, the case will most likely be referred to a specialist.

In the most severe cases, vomiting blood is a sign of a bleeding ulcer, an injury to the digestive tract, or a perforation in the stomach or intestine. If this is the case, the treatment to follow is usually emergency surgery.

Recommendations and preventions

The best way to avoid an episode of vomiting blood is to take care of your gastrointestinal health. This is achieved with a proper diet and healthy habits. Some foods increase stomach acidity and generate a greater risk of gastritis and other problems.

Among the foods that should be consumed in moderation are spicy foods. Also, everything that contains caffeine, including decaffeinated coffee and chocolate. On the other hand, it’s good to limit the intake of red meat, animal fats, and white flour products.

Alcohol is one of the substances with the greatest potential to irritate the digestive tract. Excessive and long-term consumption can cause serious damage to the stomach and intestine. Tobacco is also an irritant, as well as aspirin and ibuprofen, among others.

Taking care of your general health to prevent vomiting blood

Stress is another factor that can affect good digestive health. The best thing to do is to look for mechanisms to control it. One of the best ways to do this is through regular exercise, which protects physical and mental health.

It’s important to apply good food hygiene to prevent infections by bacteria, viruses, and parasites. You should eat slowly, chew food well, and keep your mind calm. The consumption of probiotics is highly recommended.

In conclusion, to maintain good digestive health it’s essential to take care of general health by eating a balanced and healthy diet, doing regular physical exercise, and avoiding substances that can cause long-term damage.