What does blood look like in vomit?
Fresh blood from the esophagus or from a large vessel in the stomach appears scarlet or dark red, often with clots, and usually means heavy bleeding. If blood has been in the stomach for some time, hydrochloric acid turns hemoglobin into a dark pigment, and the vomit becomes like coffee grounds - brown, with small grains. Both options are equally serious. Black, tarry stools often appear in parallel, which confirms that the source is located in the upper digestive tract.
- Scarlet blood - fresh heavy bleeding
- Coffee grounds - blood changed in the stomach
- Often combined with black stool
- The volume of blood loss cannot be assessed by eye.
- Weakness and dizziness indicate significant blood loss
Main reasons
Most often, a gastric or duodenal ulcer bleeds, especially with H. pylori infection and taking non-steroidal anti-inflammatory drugs. Erosive damage to the mucosa develops after alcohol, severe stress, burns and operations. In people with cirrhosis of the liver, the pressure in the portal vein system increases, the veins of the esophagus dilate and can rupture - such bleeding is especially dangerous. Rupture of the mucous membrane at the junction of the esophagus and the stomach occurs after repeated vomiting, including due to alcohol. Tumors and vascular anomalies bleed less often.
- Stomach and duodenal ulcers
- Erosive gastritis
- Varicose veins of the esophagus with cirrhosis
- Rupture of the mucosa after persistent vomiting
- Tumors of the esophagus and stomach
- Taking NSAIDs and anticoagulants
What to do before help arrives
Call 103 for help immediately and remain calm. The person is placed on his side or seated leaning forward so that blood and vomit do not enter the respiratory tract. Do not give anything to eat or drink, including water and medications. Do not try to induce vomiting again, do not rinse your stomach, or place a heating pad on your stomach. Cold on the upper abdomen is acceptable. Keep a sample of the vomit for your doctor and make a note of approximately how much blood was lost and when it started.
- Call 103 for help
- Lay on your side or sit leaning forward
- Avoid eating, drinking and taking medications
- Do not warm the stomach, you can apply cold
- Save the vomit sample
- Tell your doctor about medications you are taking and liver disease.
What can masquerade as bloody vomit?
Sometimes other situations are mistaken for bleeding from the stomach. When there is a heavy nosebleed or after dental surgery, a person swallows blood and it comes out with vomiting. Hemoptysis in lung diseases is distinguished by the fact that the blood is scarlet, foamy and appears when coughing, and not when gagging. Red vomit can come from beets, tomato juice, red drinks and gelatin. The doctor must figure this out: before examination, any vomiting with an admixture of red or brown is regarded as bleeding.
- Swallowed blood from nosebleeds
- Blood after tooth extraction
- Hemoptysis in lung diseases
- Coloring with beets and red drinks
- Vomiting after taking iron supplements
Examination and treatment
In the hospital, the circulatory condition is first assessed, a venous access is established, a complete blood count, coagulation parameters and blood group are taken, and if necessary, volume replacement and transfusion are started. The main method of diagnosis and treatment is endoscopy, which is performed in the first hours: the doctor finds the source and stops the bleeding with clips, coagulation or injection of drugs. For varicose veins of the esophagus, ligatures are applied. After stopping, proton pump inhibitors are prescribed, ulcers and H. pylori are treated, and in case of cirrhosis, prevention of repeated episodes is selected.
- Assessment of blood pressure, pulse and blood counts
- EGDS in the first hours
- Endoscopic bleeding control
- Volume resuscitation and blood products as indicated
- Proton pump inhibitors
- Prevention of recurrent bleeding in cirrhosis
