I have been vomiting blood

I have been sick for about six weeks now and on hospital bed. Recently I started vomiting blood and getting weak. Kindly provide information about this problem. Patrick K. Thanks Patrick for your question and wishing you speedy recovery. Vomiting blood is also called “Hematemesis” which is the medical term for vomiting significant amounts of […]

I have been sick for about six weeks now and on hospital bed. Recently I started vomiting blood and getting weak. Kindly provide information about this problem.

Patrick K.

Thanks Patrick for your question and wishing you speedy recovery. Vomiting blood is also called “Hematemesis” which is the medical term for vomiting significant amounts of blood. The blood may be bright red or black or dark brown (coffee ground colour). Hematemesis is a serious condition as it causes blood loss which may lead to shock hence it is a medical emergency and requires immediate hospitalization.

Causes of hematemesis

1. Any bleeding from the upper gastro-intestinal tract like oesophagus, stomach, or intestine can lead to hematemesis.

2. Bleeding peptic ulcer is the most common cause of blood vomiting.

3. Disorders of the blood vessels of the gastro-intestinal system.

4. Swallowing of coughed up blood or even a nose-bleed may be another factor causing blood vomiting.

5. Taking aspirin in certain people may precipitate this condition.

6. Pancreatic ulcer

7. Cancer of the oesophagus, stomach or upper intestine (benign and malignant).

8. Acute liver failure and alcoholic hepatitis can lead to blood vomiting.

9. Cirrhosis of liver, a chronic condition which causes scarring of the liver cells.

10. Stomach problems like gastritis (inflammation of the stomach) or gastric erosion (defects in the inner lining of the stomach).

11. Oesophageal disorders like oesophageal varices (enlarged blood vessels around the oesophagus) and oesophagitis (inflammation of the oesophagus).

12. Portal hypertension – a condition characterized by high blood pressure in the portal blood vessels supplying the liver.

13. Excessive use of NSAID’S (non-steroidal anti-inflammatory drugs).

14. Dieulafoy’s syndrome, a condition in which there is an artery protruding from the stomach wall.

15. Mallory-Weiss tear (vomiting and coughing causes a tear in the lining of the oesophagus due to excess pressure.)

Symptoms and signs of hematemesis

1. The person or patient may have symptoms of the problem causing hematemesis. For example, if a person or patient has a peptic ulcer there may be complaints like acidity, a feeling of fullness in the abdomen; a person having a malignant tumour may have nausea, loss of weight, malaise and loss of appetite.

2. Warning: If a person starts vomiting blood along with symptoms like confusion, nausea, fainting, rapid shallow breathing and cold clammy limbs, that is a sign that the patient might be going into shock and needs Intensive Care Unit admission straightaway.

Diagnosis of hematemesis

When the patient is brought to the hospital with hematemesis, it is imperative to know the cause, so the physician should ask for the medical history and also conduct detailed and thorough investigation. The next step is to check vital signs like pulse, blood pressure and breathing.

Treatment of hematemesis

1. Immediate treatment is to stop the blood loss. The patient is given an anaesthetic and an oesophagogastro-duodenoscopy is done at the earliest. This is a form of treatment to stop the bleeding by using a sclerosing agent on an ulcer or banding the oesophageal varices that cause bleeding. 

2. Intravenous fluids are given to maintain the blood pressure.

3. Specific treatment of the cause identified is also instituted for example in patients of peptic ulcer, antacids are administered.

4. Also if the patient has lost a lot of blood, it will require blood transfusion.