Vomiting blood, also referred to as hematemesis, is caused by a variety of medical conditions. These conditions can range from a simple nosebleed to a serious bleed in the gut.
Whatever the cause, vomiting blood is a medical emergency. It is recommended that treatment is sought immediately to determine and treat the underlying cause.
Causes of vomiting blood
The causes of vomiting blood are many and include several health problems such as:
- Stomach ulcers
- Vigorous vomiting
- Tears, irritation, or tissue loss in and of the lining of the stomach
- Enlargement of veins in the food pipe or gut
- Tumors and lesions in the stomach or food pipe
- Damage to the upper gut caused by radiation
- Infections such as hepatitis or H. pylori infection
- Use of certain medications, such as aspirin, NSAIDs, or blood thinners
- Alcoholism
- Poison ingestion
Specific medical conditions that can lead people to vomit blood include:
- Gastroenteritis
- GERD (gastroesophageal reflux disease)
- Blood vessel disorders in the gut
- Inflammation of the food pipe, gut, or pancreas
- Pancreatic cancer
- Certain liver conditions such as acute liver failure and cirrhosis or scarring
- Dieulafoy’s lesion, a condition in which an artery sticks out through the stomach wall
- Mallory-Weiss tear, a condition in which there are tears in the food pipe caused by the raised pressure of vomiting or coughing
- Portal hypertension, a condition in which there is high blood pressure in the portal vein
- Blood abnormalities such as low platelets, hemophilia, anemia, or leukemia
Vomiting blood in infants and young children can be caused by a number of other conditions such as:
- Abnormalities present at birth
- Blood clotting disorders
- A lack of vitamin K
- A milk allergy
- Swallowed blood or a swallowed object
Other at-risk groups who may experience vomiting blood include those who drink alcohol excessively and pregnant women.
Diagnosis and treatment
Treatment of hematemesis is dependent on the cause of the condition. It may require certain tests including blood tests and stool samples.
Procedures like a radiologic imaging and endoscopy may also be recommended. Radiologic imaging tests such as a CT (CAT) scan and X-ray will help the healthcare team to work out the source of the bleed in question. An endoscopy uses a lighted scope to examine the upper portion of the gut for any causes of bleeding.
The causes of vomiting blood may require treatment with certain medications, blood transfusion, and surgery.
In some cases when an arterial bleed is suspected, an angiogram may be required. Performed under sedation, this procedure requires inserting a thin tube and wire through the artery in the groin. Injected iodine dye and X-rays then help doctors to check for blockages.
