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Vomiting blood, known as hematemesis in medical terms is pretty scary. It could be a sign of a fatal condition or it could just be the dilatation of blood vessels. This article will highlight major causes, symptoms, and treatments of hematemesis.

What is Hematemesis?

Hematemesis refers to the regurgitation of copious amounts of blood from somewhere in the upper gastrointestinal tract.

The blood may originate from the mouth, pharynx, esophagus, stomach or small intestine. The blood that is vomited may be bright red, or slightly darker, appearing black.

Vomiting blood may also occur when blood is swallowed as a result of a nosebleed or forceful coughing. Slight flecks of blood in the vomit or coughing up blood in spit are known as hemoptysis. Hematemesis, on the other hand, is much more serious. The amount of blood loss may lead to shock and dizziness and may require immediate medical attention and sometimes hospitalization as well.

Before we go on to the causes of hematemesis, it is important to know what does this term actually mean. Hematemesis is 'vomiting blood' which exactly means 'blood coming from digestive system'. Do not confuse it with the term 'Hemoptysis' which means bloody sputum or blood with cough.

Causes of Hematemesis

Some of the most common causes of hematemesis involving the gastrointestinal tract include:

  • Peptic Ulcer – An inflamed or bleeding ulcer is the most common cause of vomiting blood.
  • Esophageal Disorders – These include enlarged blood vessels around the esophagus (esophageal varices) and inflammation of the esophagus (oesophagitis). 
  • Pancreatic Ulcer
  • Pancreatitis (inflammation of the pancreas)
  • Damaged blood vessels of the upper gastro-intestinal tract
  • Certain Cancers – Esophageal, stomach or upper intestinal cancer (benign or malignant).
  • Gastritis (inflammation of the stomach)
  • Gastric Erosion (abnormalities in the stomach lining)
  • Liver Cirrhosis (chronic scarring of liver cells)
  • Acute Liver Failure
  • Portal Hypertension (high blood pressure in the vessels supplying blood to the liver)

There are some other causes that may result in vomiting blood. But these cause are seen in rare cases:

  • Excessive use of Aspirin may cause hematamesis in some individuals
  • Excessive use of NSAIDs (non-steroidal anti-inflammatory drugs)
  • Mallory-Weiss tear (a tear in the lining of the esophagus due to pressure exerted during vomiting and coughing)
  • Dieulafoy’s syndrome (protrusion of an artery from the stomach wall)
  • Alcoholic Hepatitis
  • Duodenitis (inflammation in first part of small intestine)
  • Birth Defects
  • Blood Clotting Abnormalities
  • Milk allergies (usually seen in children)

Symptoms of Hematemesis

Vomiting huge amounts of blood is itself the most alarming symptom of hematemesis.

However, other symptoms may help the doctor diagnose the underlying cause of the bleeding as well.

For instance, of the origin of bleeding is a peptic ulcer, the individual is most likely to have other complaints such as abdominal discomfort, a feeling of fullness and acidity. If the underlying cause is a malignant tumor, the individual might also experience nausea, loss of appetite and weight loss.

More Serious Symptoms

If an individual experiences symptoms such as confusion, rapid shallow breathing, cold sweats and nausea, he or she may be going into shock. Immediate care must be provided in such cases.

Other serious symptoms that require urgent medical attention are:

  • Dizziness
  • Lightheadedness
  • Pale skin
  • Blurred vision
  • Low urine output
  • Weak pulse
  • Low blood pressure
  • Clammy skin

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