Vomiting blood (haematemesis)

Vomiting blood (haematemesis) could be a sign of a serious problem. If you (or someone you are with) feel weak, faint or in any way unwell, having vomited some blood, you should call 999. If you feel well, you should still go to your nearest emergency department.

Amount and colour of blood 

If you are not sure it was blood that you vomited, seek advice from your GP or GP out of hours service urgently. If you are vomiting blood, the amount and colour of blood can vary. For example:

  • you may have vomited large amounts of bright red blood
  • there may be streaks of blood in your vomit, mixed up with food
  • there may be what looks like coffee grounds in your vomit, which means the blood has been in your stomach for a few hours

If possible, keep a small sample of the vomit to show the doctor treating you. It will give them a much better idea of what's wrong.

What to expect when you see a doctor 

Unless you're well and the cause is obvious to your GP or doctor – for example, swallowing blood from a nosebleed – you should be admitted to hospital straight away for tests.

These will include blood tests and an endoscopy. An endoscopy involves examining the inside of your digestive tract with a thin, flexible tube that has a light and camera at one end.

This is to find out where in the body the blood has come from, for example, the stomach.

Common causes of vomiting blood 

If you vomit blood, it means there's bleeding somewhere in your oesophagus (the tube linking your mouth to your stomach), stomach or the first part of your small intestine (duodenum).

Below is a summary of the most likely causes of blood in the vomit. It's a rough guide that should give you a better idea of the problem.

Don't use it to diagnose yourself – always get assessment and treatment.

Stomach ulcer or severe gastritis 

If you vomit blood and also have a burning or gnawing pain in your tummy, the most likely causes are a stomach ulcer or severe inflammation of the stomach lining (gastritis).

Bleeding occurs when the ulcer or inflammation damages an underlying artery (blood vessel).

Oesophageal varices 

Oesophageal varices are enlarged veins in the walls of the lower part of the oesophagus (tube that carries food from your mouth to your stomach). They bleed, but don't usually cause any pain.

They're often caused by alcoholic liver disease. If your GP or doctor thinks oesophageal varices are the cause of blood in your vomit, you'll need to be admitted to hospital immediately.

Severe gastro-oesophageal reflux disease 

Gastro-oesophageal reflux disease (GORD) is where acid leaks out of the stomach and up into the oesophagus.

If you have severe GORD, it can irritate the lining of your oesophagus and cause bleeding.

Tear in the oesophagus 

Long periods of retching can tear the lining of your oesophagus, which can also result in bleeding.

Swallowed blood 

It's possible to swallow blood in certain circumstances – for example, after a severe nosebleed.

The above conditions may also cause you to have blood in your stools, causing black, tarry poo.

Less common causes of vomiting blood 

Less commonly, blood in your vomit may be caused by:

  • swallowing poisons – such as corrosive acid or arsenic
  • a blood condition – such as a reduced number of platelets in the blood (thrombocytopenia), leukaemia, haemophilia or anaemia
  • cancer of the oesophagus or stomach cancer – cancer may be suspected if you're over 55 and you've also lost a lot of weight; apart from that it's rare

The information on this page has been adapted from original content from the NHS website.

For further information see terms and conditions.

This page was reviewed January 2018

This page is due for review February 2020

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