What You Need to Know About Vomiting Blood

Vomiting blood, also known as hematemesis, is a serious symptom that can indicate a potentially life-threatening condition. It can be caused by various factors, such as injuries, infections, ulcers, cancers, or bleeding disorders. In this article, we will explain what vomiting blood looks like, what causes it, how it is diagnosed, and how it is treated.

Appearance of Vomited Blood

The appearance of vomited blood can vary depending on the source and severity of the bleeding. It can be:

• Bright red: This indicates fresh blood from the esophagus or stomach. It may suggest a fast-bleeding source or an acute bleeding episode.
• Red streaks mixed with food: This indicates blood from the mouth, throat, or upper GI tract. It may be due to minor causes, such as swallowing blood from a nosebleed or a mouth injury.
• Brown or black: This indicates old blood that has been in the stomach for a while. It may look like coffee grounds. It usually suggests a slower and steadier source of bleeding.

If possible, take a picture of the vomit with blood to show your doctor. This can help them determine the cause and severity of the bleeding.

Causes of Vomiting Blood

Vomiting blood can be caused by many different conditions that affect the upper GI tract (mouth, esophagus, stomach, and upper small intestine). Some of the common causes are:

• Peptic ulcers: These are sores in the lining of the stomach or duodenum (the first part of the small intestine) that are caused by acid erosion or infection by a bacterium called H. pylori. They can bleed and cause pain, nausea, and vomiting.
• Gastritis: This is inflammation of the stomach lining that can be caused by bacterial infection, heavy alcohol use, or over-the-counter painkillers (such as aspirin or ibuprofen). It can cause abdominal discomfort, loss of appetite, and vomiting blood.
• Esophageal varices: These are enlarged veins in the lower part of the esophagus that develop due to liver disease or portal hypertension (high blood pressure in the vein that carries blood from the digestive organs to the liver). They can rupture and bleed profusely, causing hematemesis and shock.
• Gastric varices: These are enlarged veins in the stomach that develop due to liver failure or portal hypertension. They can also rupture and bleed heavily, causing hematemesis and shock.
• Esophagitis: This is inflammation of the esophagus that can be caused by acid reflux, infection, allergy, or medication. It can cause difficulty swallowing, chest pain, and vomiting blood.
• Mallory-Weiss tear: This is a tear in the lining of the esophagus that occurs due to forceful vomiting or coughing. It can cause hematemesis and chest pain.
• Esophageal cancer: This is a malignant tumor that grows in the esophagus. It can cause difficulty swallowing, weight loss, and vomiting blood.
• Stomach cancer: This is a malignant tumor that grows in the stomach. It can cause abdominal pain, weight loss, and vomiting blood.
• Other causes: These include benign tumors of the stomach or esophagus, defects in gastrointestinal tract blood vessels (such as Dieulafoy’s lesion), pancreatic cancer, pancreatitis (inflammation of the pancreas), acute liver failure, cirrhosis (scarring of the liver), internal injuries, organ bleeding, organ rupture, swallowed objects, swallowed blood (from nosebleeds or oral surgery), blood-clotting disorders (such as hemophilia), vitamin K deficiency (which affects blood clotting), milk allergy (in infants and children), etc.

Diagnosis of Vomiting Blood

If you vomit blood, you should seek immediate medical attention. Your doctor will ask you about your medical history, symptoms, medications, alcohol use, and possible exposure to infections. They will also examine you physically and check your vital signs (such as pulse, blood pressure, temperature, and breathing rate).

To determine the cause and source of the bleeding, your doctor may order some tests, such as:

• Blood tests: These can check your blood count (to see if you have anemia or infection), your clotting factors (to see if you have a bleeding disorder), your liver function (to see if you have liver disease or portal hypertension), your kidney function (to see if you have kidney failure), your electrolytes (to see if you have dehydration or imbalance), your H. pylori status (to see if you have a stomach infection), etc.
• Urine tests: These can check for blood or infection in your urine.
• Stool tests: These can check for blood or infection in your stool.
• Endoscopy: This is a procedure that uses a thin, flexible tube with a camera and a light (called an endoscope) to examine the inside of your upper GI tract. It can help identify the location and severity of the bleeding, as well as take samples (biopsies) for further testing.
• X-rays: These can show the shape and size of your esophagus, stomach, and duodenum, as well as detect any foreign objects or masses.
• CT scan: This is a type of imaging test that uses X-rays and a computer to create detailed pictures of your internal organs. It can help detect any tumors, inflammation, or bleeding in your abdomen or chest.
• Ultrasound: This is a type of imaging test that uses sound waves and a computer to create pictures of your internal organs. It can help detect any abnormalities in your liver, spleen, pancreas, or gallbladder.

Treatment of Vomiting Blood

The treatment of vomiting blood depends on the cause and severity of the bleeding. Some of the possible treatments are:

• Medications: These can include antibiotics (to treat infections), proton pump inhibitors (to reduce acid production), H2 blockers (to reduce acid secretion), antacids (to neutralize acid), cytoprotective agents (to protect the stomach lining), antiemetics (to prevent nausea and vomiting), blood transfusions (to replace lost blood), clotting factors (to stop bleeding), etc.
• Endoscopic therapy: This is a procedure that uses an endoscope to deliver various treatments to stop the bleeding, such as injection of medications, application of heat or electricity (cauterization), placement of clips or bands (ligation), insertion of balloons or stents (to compress or open the bleeding vessels), etc.
• Surgery: This is a procedure that involves making an incision in your abdomen or chest to access and repair the bleeding site. It may involve removing part or all of your stomach or esophagus, tying off or bypassing the bleeding vessels, removing tumors or ulcers, etc.
• Other treatments: These may include angiography (a procedure that uses X-rays and dye to visualize and treat the bleeding vessels), embolization (a procedure that uses a catheter to block the bleeding vessels with coils or particles), radiotherapy (a treatment that uses high-energy rays to kill cancer cells), chemotherapy (a treatment that uses drugs to kill cancer cells), etc.

Conclusion

Vomiting blood is a serious symptom that requires urgent medical attention. It can be caused by various conditions that affect the upper GI tract, such as ulcers, gastritis, esophageal varices, gastric varices, esophagitis, Mallory-Weiss tear, esophageal cancer, stomach cancer, etc. The diagnosis of vomiting blood involves taking a medical history, performing a physical examination, and ordering some tests, such as blood tests, urine tests, stool tests, endoscopy, X-rays, CT scan, ultrasound, etc. The treatment of vomiting blood depends on the cause and severity of the bleeding. It may include medications, endoscopic therapy, surgery, or other treatments.