Vomiting blood (Hematemesis) Causes, Symptoms & Treatment

Vomiting blood (Hematemesis) Causes, Symptoms & Treatment

Hematemesis is the term for vomiting up blood. It can also be described as either bright red blood from the upper gastrointestinal tract or dark, fresh blood from the stomach. 

This can occur due to various issues, ranging from peptic ulcers to esophageal cancer and a rare condition called Mallory-Weiss syndrome.

Hematemesis is a common symptom that warrants further clinical investigation in most patients. Understanding the causes of this ominous sign will aid the practitioner in correctly diagnosing the underlying pathology and managing this condition.

While vomiting blood can be a very alarming symptom, it is not always a sign of a severe or life-threatening condition; however, you should consider it a medical emergency and consult a doctor immediately.

Causes of Hematemesis

Causes of Hematemesis vary depending on the underlying condition and can range from a mild to a life-threatening situation. Common causes of Hematemesis include:

Mallory-Weiss Tear

Mallory-Weiss syndrome is a disorder that develops when blunt trauma or powerful eruption of the stomach causes a tear in the upper portion of the stomach as well as the mucous membrane of your esophagus. 

Blood or mucosal fluids then wash over the injury site, causing severe vomiting and abdominal pain.

About 2 million people suffer from a tear in the esophagus muscle every year, which may cause temporary esophageal obstruction and result in life-threatening complications such as pulmonary embolism and vascular necrosis.

Peptic Ulcer

Peptic ulcer disease is a type of ulcer that affects the stomach lining or the first part of the small intestine (duodenum).

Peptic ulcers result when the mucous membrane, or inner layer of tissue, the stomach or small intestine, is injured. This irritation causes blood vessels to leak and stomach fluids to leak into the ulcerated tissue.

There are two types of peptic ulcers: Gastric ulcers, an inflammation of the stomach lining, duodenal ulcers, and duodenal lining.

Avoidance of triggers is the most reliable way to prevent and avoid peptic ulcer disease. The standard medical practice uses endoscopic removal (ERCP) of the upper-GI tract if the ulcer doesn’t heal and uses proton-pump inhibitor (PPI) medicines if bleeding.

Fatty Liver Disease

Liver disease is often caused by drinking too much alcohol and drug-taking. Fatty liver disease happens when fat in the liver accumulates in triglycerides. 

This is a common problem with obese people, and other factors such as consuming a fatty diet or too much sugar can trigger the fatty liver disease.

Fatty liver disease is a significant health problem worldwide and becomes dangerous over time. Both conditions typically become more hazardous over time. 

You can view the long-term prognosis of fatty liver disease in the context of mortality rates or survival rates or by considering therapies or other interventions.


Anemia, also called iron deficiency anemia, is a condition in which there aren’t enough healthy red blood cells to carry adequate oxygen to the body’s tissues.

So if you have anemia, you may not be getting enough oxygen and maybe experience symptoms such as weakness and pale skin. This can progress to symptoms like increased fatigue and heart palpitations.

Diagnosis of Hematemesis

Your doctor will ask you questions about your symptoms to determine the cause of blood in your vomit. If your doctor believes it’s necessary, he may order a blood test to determine how much blood you have lost.

Your doctor may perform an upper endoscopy while under sedation to examine your GI tract. If you are bleeding because of another condition, such as cancer, your doctor may order imaging tests such as CT scans, ultrasounds, X-rays, MRI scans to examine your internal organs.

How to manage Hematemesis

  • If you experience Hematemesis, it is best to avoid triggers such as NSAIDs and aspirin, as these medications can cause stomach bleeding. Consult your primary healthcare provider to discuss your options.
  • Avoid smoking as the nicotine present in cigarettes damages blood vessels. You can speak with a support group if you need help with quitting.
  • Avoid alcohol and caffeine as these substances irritate and damage both the stomach and intestine linings.
  • Alcohol and caffeine can irritate and damage the lining of your stomach or intestine. Talk to your healthcare provider if you need help to quit drinking alcohol.
  • Eat healthy meals.

How to treat Hematemesis

There is no specific treatment course for Hematemesis. Treatment varies depending on the condition.

Depending on the cause and amount of blood lost, your doctor may prescribe medications to ease discomfort and perform a blood transfusion to replace lost blood.

If the condition is severe, a gastroenterologist may be able to help.