Throwing Up Blood: Top 11 Causes (& What to Do)

What is it:

Throwing-up blood is often a sign of abnormalities or malfunctioning of the organs along the digestive tract, like the stomach, esophagus or beginning of the intestines. It is a symptoms that is commonly associated with gastritis and ulcers.

Vomiting blood is medically referred to as hematemesis, and can vary depending on severity. Patients may report small or large amounts of blood, both of which should be reported to a doctor. 

The doctor may order testing like an endoscopy, which assesses the integrity of the digestive tract. Treatment is usually aimed at minimizing further blood losses and resolving the underlying cause.

Why am I vomiting blood?

Throwing-up blood can be a sign of various health conditions, such as: 

1. Esophageal varices  

Esophageal varices are blood vessels in the esophagus that have become dilated. This can happen due to obstructed circulation within the hepatic portal, which is responsible for draining blood around the abdominal organs. With decreased flow or obstructions in the hepatic portal, pressure in the vessels around the esophagus will increase. This increased pressure causes dilation and bleeding. Blood can be noted in vomit or in the stools (which will appear to be black and have a foul odor), and many people may also experience dizziness and pallor. 

What to do: If you suspect varices and you are vomiting blood, you should proceed immediately to the emergency room to stop the bleeding. Once diagnosed, patients are usually monitored by a gastroenterologist. Treatment is aimed at improving the underlying cause of bleeding and preventing further hemorrhages. The doctor will often prescribe beta-blockers and may recommend surgery to repair the varices. 

2. Gastritis

Gastritis is characterized by inflammation in the stomach, which can occur when the protective mucus lining is destroyed and left untreated. Without the mucus lining, the stomach is prone to developing ulcers, which can bleed over time and lead to bloody vomit and dark stools.

Other symptoms associated with gastritis include abdominal discomfort, burning in the stomach and nausea. If you think you may have gastritis, report your symptoms using our online gastritis quiz. 

What to do: You are advised to see your doctor for assessment to determine whether you have stomach inflammation. Once identified, treatment can be initiated. Usually it involves the use of stomach protectors to prevent further inflammation. These medications work by creating a barrier to block stomach acid from irritating stomach tissue, which promotes healing and relieves symptoms. Learn more about the gastritis treatment your doctor may recommend.

Diet also plays a role in decreasing stomach inflammation. You should avoid spicy foods, sauces, fatty foods and alcohol, for example. Read more about what foods you should eat and what to avoid when treating gastritis. 

3. Esophagitis

Esophagitis is an inflammation that affects the esophagus, which is a structure that connects the mouth to the stomach. Most times, esophagitis is caused by infections, gastritis or reflux. People with esophagitis usually have excess acid in the esophagus, which can cause symptoms like heart burn, a bitter taste in the mouth, a sore throat and blood in vomit. 

Read more about erosive esophagitis and why it can happen.

What to do: It is important to identify the underlying cause of esophagitis to start appropriate treatment. Most times, the doctor will prescribe medication to decrease stomach acid production, like omeprazole. Dietary changes may also be required until the inflammation resolves and to prevent further worsening. 

4. Stomach ulcers 

Stomach ulcers mostly occur due to chronic gastritis that is left untreated. Stomach tissue that is constantly irritated by stomach acid can lead to the appearance of ulcers. 

Stomach ulcers usually cause stomach pain between meals or at night that does not resolve with medications. They can also cause nausea and vomiting with blood. Read more about stomach ulcer symptoms that can emerge.

What to do: Similar to gastritis or esophagitis, you should use stomach protectors as prescribed by your doctor to prevent further irritation of stomach tissue. This will help to heal the ulcers. Dietary changes should also be considered. 

5. GERD

GERD, or gastroesophageal reflux, is the backflow of stomach contents into the esophagus and towards the mouth. This condition causes constant pain and inflammation of the esophageal wall, and in severe cases, it can cause bleeding and the appearance of bloody vomit.

Other symptoms of GERD include heartburn, food regurgitation, indigestion or excessive belching. Learn more about the symptoms of GERD and acid reflux.

What to do: GERD treatment should be oriented by a gastroenterologist, who may prescribe antacids, GERD medications that inhibit acid production, gastric protectors or gastric emptying accelerators.

The doctor may also recommend a GERD diet, which can be guided by a registered dietitian.

6. Nose bleeds

When nose bleeds are very intense, the person may involuntarily swallow blood and then feel the urge to eliminate it by vomiting. Most times, throwing-up blood after a nose bleed is not serious, however you should monitor how often this happens and how much blood you lose. You should see your doctor if you vomit blood frequently after nose bleeds. 

Learn more about what can cause nose bleeds and what to do.

What to do: To stop nose bleeding and prevent eventual bloody vomit, you should apply pressure on the nostrils with a napkin and apply ice to the nose. It also helps to lean your trunk forward instead of raising your chin up, to prevent blood from being swallowed.

7. Chronic pancreatitis

Chronic pancreatitis is the progressive inflammation of the pancreas, which can cause blood vessels around the pancreas to rupture and result in bloody vomit.

Other symptoms of this condition include yellowing eyes, intense pain on the left side of the stomach that can radiate to the back, as well as nausea or fever.

What to do: treatment usually involves hospitalization with IV fluids and painkillers prescribed by the gastroenterologist to control the pain. Surgery may be recommended in more serious cases. It is also important to make changes to your diet, avoiding fatty foods, and to take pancreatic enzyme supplements as recommended by your doctor. Learn more about the pancreatitis diet your doctor may recommend.  

8. Liver cirrhosis

Liver cirrhosis can also lead to vomiting with blood, as well as yellowing of the eyes and skin, dark urine, whitish stools or swelling of the legs, especially when it is in its most advanced stage. Check-out our liver disease symptoms quiz to determine whether your symptoms are related to a liver problem.

This disease occurs when alcohol, fatty liver or hepatitis cause permanent damage to the liver cells, causing these cells to be replaced by fibrous tissue, which impedes optimal liver functioning.

What to do: A liver specialist should be consulted to start treatment, which varies depending on what caused the cirrhosis. The doctor  may recommend discontinuing alcohol consumption, starting a low-fat diet and using diuretic medication to reduce swelling in the body. In more serious stages of liver cirrhosis, the doctor may recommend a liver transplant. 

9. Mallory-Weiss syndrome

Mallory-Weiss syndrome is a condition in which there is a sudden increase in pressure in the esophagus, which can cause the tissue that joins the stomach to the esophagus to rupture. Symptoms of this condition include throwing up blood, abdominal pain and chest pain.

This syndrome can be caused by frequent vomiting, intense coughing, vomiting urges or constant hiccups.

What to do: You should seek urgent medical assistance or go to the nearest emergency room to stop the bleeding, which can be done through endoscopy. The doctor will apply medication directly to the lesion during this procedure, and will cauterize the area or insert a clip to fuse the lesion. If the bleeding does not improve with endoscopy, the doctor may recommend surgery. 

10. Portal hypertension

Portal hypertension is the increase in pressure in the portal vein that carries blood from the abdominal organs to the liver. This can alter its functioning and cause bleeding, leading to throwing up blood and very dark, foul-smelling stools.

In serious cases, mental confusion and even fainting can occur.

What to do: You should go immediately to the emergency room to start the most appropriate treatment, which can be medication, endoscopic therapy, surgery or liver transplantation. Here's how portal hypertension is treated

11. Cancer

The presence of stomach or esophageal tumors can lead to blood being eliminated through the mouth. This symptoms is more frequent in advanced stages of cancer. In addition to throwing-up blood, you may notice other symptoms like loss of appetite, weight loss, difficulty swallowing, dark stools with a foul odor, a feeling of a full stomach, excessive fatigue and abdominal discomfort. 

Learn more about the symptoms of stomach cancer that you shouldn't ignore.

What to do: If esophageal or stomach cancer is suspected, your doctor should order testing like an endoscopy or biopsy for confirmation. Once diagnosed, treatment should be started promptly to avoid further cancer progression and complications.

Babies throwing up blood

Babies who vomit blood should be assessed by their doctor or pediatrician. Usually it is a sign of a hemorrhagic disease (like a vitamin K deficiency), liver disease, or a serious infection. Babies who breastfeed can also swallow blood from cuts or fissures in the mother’s nipple - this is a less serious condition.

In children, it is common to notice blood in vomit after losing a tooth, after a nose bleed, with strong coughing or from certain medications.