Why are you vomiting blood?

Posted by Master, Doctor Mai Vien Phuong - Gastrointestinal Endoscopy - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital

Vomiting blood is the reflux of gastric juice with blood, or just blood. Vomiting blood can be a concern, but in some cases minor causes can trigger the problem. This includes swallowing blood from mouth trauma or nosebleeds.

There are many causes of vomiting blood. They range in severity from mild to severe and are often the result of injury, illness, or drug use.
Vomiting blood can be caused by minor conditions such as:
Esophageal irritation Nosebleeding Blood Swallowing Esophageal tear from chronic cough or vomiting Swallowing a foreign object Other common causes of vomiting blood include:
Stomach ulcers Gastritis or gastritis Aspirin side effects Nonsteroidal anti-inflammatory drug side effects Pancreatitis More serious causes of vomiting blood include:
Cirrhosis Esophageal cancer Erosion stomach lining Pancreatic cancer All cases of vomiting blood should be reported to your doctor.

In fact a number of symptoms may appear along with vomiting blood. These symptoms include but are not limited to:
Nausea Abdominal discomfort Abdominal pain Vomiting of stomach contents Vomiting blood can be a sign of a serious medical emergency. Call 911 right away if you experience any of the following symptoms:
Dizziness Blurred vision Heart palpitations Change in breathing Cold or rough skin Confusion Fainting Severe abdominal pain Vomiting blood after a seizure love

There are many potential health problems that can cause you to vomit blood. To make a diagnosis, your doctor will start by asking questions about your symptoms and whether you have had recent related medical conditions.
Your doctor may order imaging tests to look inside your body. Scans show abnormalities in the body such as broken organs or abnormal growth. Common imaging tests used for these purposes are:
Endoscopic CT esophagogastroduodenoscopy , a device that allows your doctor to look at your stomach Ultrasound X-ray MRI Your doctor may order an upper gastrointestinal endoscopy to look for blood in your stomach. This procedure is done while you are on sedation. Your doctor will place a small, flexible tube called an endoscope into your mouth and down into your stomach and small intestine. A fiber-optic camera in the tube allows the doctor to see the contents of the stomach and check internally for any sources 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 bleeding is the source of inflammation, infection, or cancer. Your doctor may order additional tests based on your blood count results.

Choking, aspiration pneumonia or respiratory failure are among the main complications of hematemesis. This can lead to a pool of blood in your lungs, impairing your ability to breathe. Vomiting aspiration pneumonia, although rare, can be life-threatening if not treated immediately.
People at risk of aspiration include:
Elderly people People with a history of alcohol abuse People with a history of stroke People with a history of disorders affecting the ability to swallow Depending on the cause , vomiting blood can cause additional health complications. Anemia is another complication of excessive bleeding. It is a deficiency of healthy red blood cells, a condition that occurs especially when blood loss is rapid and sudden.
However, people with slowly progressing diseases, such as gastritis or those using chronic NSAIDs may develop anemia for weeks to months. In this case, anemia may remain asymptomatic until their hemoglobin or blood count is very low.
Vomiting of blood due to heavy bleeding can also lead to hypovolemic shock. The following symptoms are signs of shock:
Dizziness when standing Rapid, shallow breathing Low urine output Cold, pale skin If not treated immediately, shock can lead to a drop in blood pressure followed by kissing coma and death. If you experience any of these symptoms of shock, have someone else take you to the emergency room.

Depending on the amount of blood lost, you may need a blood transfusion. A blood transfusion replaces the lost blood with donor blood. Blood is delivered into your vein through an IV line.
You may also require intravenous fluids to rehydrate your body. Your doctor may prescribe medication to stop vomiting or reduce stomach acid. If you have an ulcer, your doctor will prescribe medication to treat it.
In some more severe cases of upper gastrointestinal bleeding, your doctor may refer you to a gastroenterologist. The gastroenterologist may perform an upper gastrointestinal endoscopy to not only diagnose but also treat the source of the bleeding. In severe cases, such as a perforation of the stomach or intestines, surgery may be necessary. Severe cases may also include bleeding ulcers or internal lesions.

Certain foods and drinks increase the likelihood of vomiting blood. These include but are not limited to highly acidic foods and alcoholic beverages. If you regularly consume these foods or drinks, your doctor can help you create a special diet to reduce this risk.
In case you have prolonged vomiting blood, accompanied by other health abnormalities, you should go to medical facilities for examination and specific evaluation.

References
Mayo Clinic Staff. (2017). Anemia.
mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-20351360
Mayo Clinic Staff. (2018). Vomiting blood.
mayoclinic.com/health/vomiting-blood/MY00571/METHOD=print
Upper GI bleeding. (n.d.).
summitmedicalgroup.com/library/adult_health/upper_gi_bleeding/