Hematemesis (Vomiting Blood): Causes, Diagnosed & Treatment
Hematemesis is the medical terminology for vomiting blood. Vomiting blood regurgitates (vomits) bloody stomach contents. The vomited blood may appear as bright red, dark red, or look like coffee grounds.
These minor situations are unlikely to cause any damage in the long term. Vomiting blood can also be caused by more serious conditions such as internal injury, organ bleeding, or organ rupture.
Regurgitated blood may appear brown, dark red, or bright red in color. Brown blood often looks like coffee grounds when vomited. The color of vomited blood can often show your doctor the source and severity of the bleeding.
For example, darker blood shows that the bleeding is from an upper gastrointestinal source, such as the stomach. Darker blood is a less intense and regular source of bleeding.
Bright red blood often shows an acute bleeding episode originating from the esophagus or stomach. This can be a source of rapid bleeding.
The colour of the blood in the vomit may not always show the source and severity of the bleeding, but it should always prompt your doctor to investigate.
If you vomit a large amount of blood, usually 500 cc or the size of a small cup, or if you vomit blood with dizziness or changes in breathing, call emergency immediately.
What causes Hematemesis?
There are several causes of vomiting blood. Most of them are very serious and require immediate medical attention. The causes can include:
- A tear in the esophagus's lining, caused by excessive vomiting
- Swelling of the veins ( varicose veins) in the lower esophagus and stomach is a common hematemesis cause, often seen in people with severe liver damage, including those with long-term alcoholism.
- Stomach bleeding or duodenal ulcer
- Irritation or swelling of the esophagus called esophagitis
- A benign or cancerous tumor of the stomach or esophagus
- A serious injury to the abdominal area, caused by a car accident or a blow to the abdomen
- Inflammation of the stomach called gastritis
- Taking too much aspirin or nonsteroidal anti-inflammatory drugs
- A condition called Dieulafoy's lesion, which affects an artery in the wall of the stomach
- Inflammation of the small intestine called duodenitis
- Pancreatic cancer
What are the Symptoms of Hematemesis?
The symptoms of hematemesis include:
- Vomiting Blood: The primary symptom is the presence of blood in vomit, which may appear bright red or have a "coffee-ground" appearance if the blood has been in the stomach for a while.
- Abdominal Pain: Discomfort or pain in the stomach area may accompany the vomiting, often related to the underlying cause of the bleeding.
- Nausea: Persistent nausea is common and may occur alongside the vomiting of blood.
- Signs of Shock: In severe cases, symptoms like dizziness, rapid heartbeat, pale skin, and low blood pressure may indicate significant blood loss and require immediate medical attention.
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Get A Second OpinionHow Is Hematemesis Diagnosed?
Many potential health problems could cause you to vomit blood. To make a diagnosis, your doctor will start by asking you about your symptoms and whether you've been recently injured.
If diagnosed hematemesis is suspected, your doctor may order an imaging test to examine the inside of your body. Imaging tests reveal abnormalities in the body, such as ruptured organs or abnormal growths. Common imaging tests used for these purposes are:
- CT scan
- Endoscopy a device that allows your doctor to look into your stomach
- Ultrasound
- X-ray
- MRI
Your doctor may order an upper endoscopy to look for blood in the stomach. This procedure is performed while you are sedated. Your doctor will place a small flexible tube called an endoscope in your mouth and your stomach and your small intestine.
A fiber-optic camera in the tube allows your doctor to see the contents of your stomach and examine you internally for any source of bleeding.
Your doctor may order a blood test to check your complete blood count. This helps assess the amount of blood lost. A biopsy may also be done to determine if the source of the bleeding is an inflammatory, infectious, or cancerous source. Your doctor may order additional tests depending on your blood count result.
What are the Treatments of Hematemesis?
If you vomit blood, your healthcare team will first try to stabilize any low blood pressure, breathing problems, or other complications from excessive blood loss. You may need a blood transfusion, breathing help, and medicine for your blood pressure or to lower stomach acid levels. You may also need IV fluids and possibly surgery.
Once a patient is stable, the cause of vomiting blood will be treated. To determine the cause, several tests can be performed. These include:
- Blood tests to take a complete blood count, check blood chemistry and clotting function
- Liver function tests
- X-rays
- A nuclear medicine scan to look for any active bleeding in the gastrointestinal tract
- A rectal exam
- Insertion of a tube through the nose into the stomach to check for the cause of the blood loss
- A test called an esophagogastroduodenoscopy (EGD) to look for sources of bleeding in the upper digestive tract
Once the cause of the vomiting blood is determined, your doctor will determine the best treatment plan that will address both your symptoms and the underlying condition causing the vomiting.
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Book an AppointmentWhen to Seek Medical Help for Vomiting Blood?
- Vomiting blood, known as hematemesis, is a concerning symptom that should never be ignored. While some cases may result from minor causes, such as a small tear in the esophagus from excessive vomiting, it can also point to more serious health issues, including internal bleeding, organ damage, or gastrointestinal disorders.
- If you experience large amounts of blood or notice any other concerning symptoms like dizziness, rapid heartbeat, nausea or weakness, it’s crucial to seek medical care as soon as possible. Blood loss from vomiting can lead to dangerous complications, including shock, organ failure, or even death.
- Remember, even if the blood seems minimal, always consult a healthcare professional right away. Early detection and intervention are key to preventing serious outcomes.
Citations
Biliary Tract Hemorrhage as a Cause of Hematemesis
Frequently Asked Questions
1. What is the difference between Haemoptysis and Haematemesis?
Hemoptysis is the coughing of blood from the airways below the level of the larynx. Hemoptysis should be differentiated from hematemesis is vomiting of blood from the gastrointestinal (GI) tract.
2. Can alcohol Hematemesis?
Regular overuse of alcohol can cause liver scarring and other medical conditions. The blood vessels can then burst, causing excess blood in the vomit. Weakness, fainting, and rectal bleeding may also accompany hematemesis.
3. Is coffee ground emesis the same as Hematemesis?
Ground coffee vomit is vomit that looks like coffee grounds. This happens because of the clotted blood in the vomit. Vomiting blood is also known as hematemesis or ground coffee vomiting.
4. What causes hematemesis?
Hematemesis can be caused by various conditions, including peptic ulcers, gastric erosions, esophageal varices, or severe gastroenteritis. It often results from bleeding in the upper gastrointestinal tract.
5. Can hematemesis be a sign of cancer?
Yes, hematemesis can sometimes be a sign of gastrointestinal cancers, such as stomach or esophageal cancer. It is important to investigate the cause thoroughly to rule out or confirm cancer and to initiate appropriate treatment.
