Bloody Vomit: What Causes It And What Do I Do If It Happens?

July 4, 2023
Bloody Vomit: What Causes It And What Do I Do If It Happens?

Vomiting blood can be a scary occurrence. And for good reason. It may be a sign of a severe disorder in your digestive tract, also known as gastrointestinal (GI) bleeding, that requires immediate medical attention. Hence, you should not take things lightly and get them thoroughly assessed.


Excessive GI bleeding is, without a doubt, dangerous. However, you should also be concerned about blood spotting as small bleeding amounts can also result in several issues too, such as low blood counts or anaemia. Hence, the reason why we emphasised the importance of getting your bloody vomit assessed immediately.


Where is the blood stemming from?

GI bleeding can happen throughout your GI tract. In the case of bloody vomit, the root cause of it would be GI bleeding in the upper GI tract – the oesophagus, stomach, or the upper portion of the small intestine. In fact, the reason blood is present in your vomit is because blood irritates the stomach lining, which leads to nausea and vomiting symptoms.


In the oesophagus, the primary concern with bloody vomit, and also the most dangerous ones, are oesophageal varices due to liver cirrhosis and oesophageal cancer. Both of which are life-threatening diseases that must be diagnosed as early as possible.


Less severe causes could be Mallory-Weiss tear, in which the pressure caused by vomiting and retching due to external factors, such as food poisoning or alcohol intoxication, is so significant that the lower oesophagus lining tears and bleeds. Bloody vomit could also be caused by reflux oesophagitis, which ends up eroding into a blood vessel.


In the duodenum and stomach, the primary concerns of bloody vomit are gastric varices due to liver cirrhosis and stomach cancer. Less severe causes could be spontaneous bleeding of abnormal blood vessels, peptic ulcers in the initial portion of the duodenum or stomach, or gastritis caused by excessive alcohol consumption or taking Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).


At the end of the day, no matter how much blood is present in your vomit, it is imperative that you make an appointment with a gastroenterology clinic as soon as possible.


How is the cause of bloody vomit diagnosed?

Bloody vomit is usually a call for immediate treatment. In fact, patients with bloody vomit are usually admitted to the hospital where a general surgeon or gastroenterologist is present.


A medical test is taken to detect the history or presence of drugs or NSAIDs that reduces the clotting ability of blood, peptic ulcer disease, prolonged excessive consumption of alcohol that leads to liver cirrhosis, or Hepatitis B or C infections. A history of vomiting or retching combined with prolonged excessive consumption of alcohol or food poisoning points the issue towards Mallory-Weiss tear. A history of acid regurgitation or heartburn points the issue towards oesophageal cancer or oesophagitis. Further signs of cancer could be dysphagia (swallowing difficulty) as well as gradual loss of weight and appetite.


If the bleeding is recurrent or in significant amounts, the blood may find its way down the GI tract and be converted by our gut microbiome in the large intestine to become Melaena, which refers to black-coloured stools. Usually, the gastroenterologist would inquire about the presence of Melaena, conducting a rectal examination too. In fact, some patients develop Melaena first, then bloody vomits.


In individuals who vomit blood, a gastroscopy will usually be conducted. It is a form of an endoscopic test, allowing the gastroenterologist a direct view of the upper GI tract to diagnose the cause of your bloody vomit. Besides diagnosing the cause, the endoscopic test also allows the gastroenterologist to stop the bleeding using Hemospray, which is a fine powder that is sprayed over a bleeding vessel to stop it, metallic clips, heat devices or injections. Bleeding gastric varices are stopped by injecting a form of super-glue, while oesophageal varices are tied up by rubber bands.



Vomiting blood is not necessarily life-threatening immediately. It all depends on how much blood loss has occurred and whether the bleeding is still occurring at the time of assessment. If considerable blood loss has occurred, it can be replaced through intravenous blood or fluid products. After which, a gastroscopy will be conducted to diagnose and stop the bleeding if necessary, followed by appropriate treatment procedures for the underlying cause.


At GUTCARE, our team of gastroenterologists are all experienced in providing optimal gut care. They have seen all sorts of gut conditions-related symptoms, from IBS symptoms to diarrhoea symptoms. For optimal digestive health, look no further than our gastroenterology clinic today!


Click here to make an appointment with us today!



About-us-Have-an-enquiry-scaled 1-min

You may also send in an enquiry via our online form if you have questions pertaining to your visit or consultation.

Find doctor thumbn

Unsure of which doctor to speak to? Take a look at our doctors’ profile to find out more.