Overview

Haematemesis, commonly known as vomiting blood, is a serious symptom that may indicate bleeding in the upper digestive tract. It can occur due to stomach ulcers, inflammation of the stomach lining, tears in the food pipe or enlarged veins associated with liver disease. The blood may appear bright red, dark brown or similar to coffee grounds.

At Sarvodaya Hospital, patients experiencing gastrointestinal bleeding require urgent medical assessment. The treatment plan depends on the patient's symptoms, medical history, examination findings and response to initial care. The availability of specific investigations and procedures should be confirmed at the intended hospital location.

Symptoms Associated with Haematemesis

• Blood may be bright red, dark brown or resemble coffee grounds.
• This may occur when blood loss affects circulation.
• Blood loss may reduce the body's ability to carry oxygen.
• These can be warning signs of significant blood loss.
• The heart may beat faster in response to reduced blood volume.
• This may occur with significant blood loss or anaemia.
• Discomfort may be associated with ulcers, gastritis or other digestive conditions.
• Digested blood can make stools appear black and sticky.
• These may indicate severe blood loss and require emergency care.

Common Causes of Vomiting Blood

• Peptic Ulcers
• Gastritis
• Oesophageal Varices
• Tears in the Food Pipe
• Oesophagitis and Other Conditions
• Stomach or Oesophageal Cancer
• Abnormal Blood Vessels in the Digestive Tract
• Severe Vomiting and Other Upper Digestive Tract Injuries

Diagnosis of Haematemesis

The first priority is to assess the patient's condition and stabilise them if necessary. Doctors then investigate the likely source of bleeding and determine whether urgent intervention is required.

• Initial Assessment : The medical team checks vital signs, including blood pressure, pulse and breathing. They may ask about the amount and appearance of blood, previous digestive problems, liver disease, alcohol use and medicines that may affect bleeding.
• Upper GI Endoscopy : An upper gastrointestinal endoscopy is a key investigation for many cases of haematemesis. A doctor passes a thin, flexible tube with a camera through the mouth to examine the oesophagus, stomach and duodenum.
• Additional Investigations : If endoscopy does not identify the source of bleeding or bleeding continues, doctors may recommend additional investigations. These may include CT angiography or catheter angiography to help locate the affected blood vessel.

Benefits of Timely Haematemesis Treatment

• Identify the source of upper gastrointestinal bleeding.
• Stabilise circulation and manage significant blood loss.
• Control bleeding through endoscopic or other specialist procedures.
• Reduce the risk of complications associated with severe blood loss.
• Treat underlying causes such as peptic ulcers or pylori infection.
• Reduce the likelihood of recurrent bleeding through appropriate follow-up.
• Support recovery through individualised treatment and monitoring.

Complications if Upper GI Bleeding Is Not Treated

• Anaemia: Blood loss can reduce haemoglobin levels and cause weakness, fatigue or breathlessness.
• Low blood pressure: Significant blood loss can reduce circulation to vital organs.
• Hypovolaemic shock: Severe blood loss may prevent the body from supplying enough oxygen to its organs.
• Organ damage: Prolonged inadequate blood flow can damage vital organs.
• Recurrent bleeding: The original bleeding site may bleed again if the underlying cause is not adequately treated.
• Need for emergency intervention: Persistent bleeding may require repeat endoscopy, interventional radiology or surgery.
• Life-threatening complications: Severe gastrointestinal bleeding can be fatal without timely treatment.

Prevention and Lifestyle Modifications

• Follow the prescribed treatment plan: Take medicines as directed and attend recommended follow-up appointments.
• Complete pylori treatment: If the infection is confirmed, complete the prescribed course and ask your doctor whether follow-up testing is needed.
• Review painkillers and other medicines: NSAIDs and certain other medicines can increase bleeding risk. Discuss alternatives with your doctor when appropriate.
• Do not stop prescribed blood thinners independently: If you take anticoagulants or antiplatelet medicines, the treating team should guide any changes.
• Manage underlying liver disease: Patients with liver disease should follow their specialist's advice and attend recommended monitoring.
• Avoid smoking and limit alcohol: These measures may support digestive health and are particularly important when alcohol-related liver disease is a concern.
• Attend follow-up investigations: Your doctor may recommend repeat endoscopy or other tests, depending on the cause and treatment findings.

When Should You Seek Emergency Care?

• Black, tarry stools.
• Dizziness, fainting or confusion.
• Cold, clammy or unusually pale skin.
• Rapid breathing or a racing heartbeat.
• Severe abdominal pain.
• Marked weakness or breathlessness.

Pre- and Post-Treatment Care

Before Treatment

• Share your medical history: Tell the treating team about previous ulcers, liver disease, digestive conditions and any earlier episodes of bleeding.
• Provide a complete medicine list: Include prescription medicines, over-the-counter products, supplements, blood thinners and painkillers.
• Describe the symptoms: Explain when vomiting began, the appearance of the blood and whether you have black stools, abdominal pain or dizziness.
• Follow emergency instructions: Do not delay emergency care to collect medical records or prepare for a routine appointment.
• Discuss the treatment plan: Once your condition has been stabilised, the medical team can explain the proposed investigations, procedures and potential risks.

After Treatment

• Take medicines as prescribed: Follow the recommended dose and duration, including any acid-suppressing or infection-related treatment.
• Attend follow-up appointments: Your doctor may review symptoms, blood results and the need for further investigations.
• Follow advice about food and fluids: The timing of eating and drinking after treatment depends on the severity of bleeding and the procedure performed.
• Review medicines with your doctor: Do not restart or stop blood thinners, aspirin or anti-inflammatory medicines without medical advice.
• Watch for recurrent bleeding: Vomiting blood, passing black stools, faintness or worsening weakness requires immediate medical assessment.
• Treat the underlying cause: Follow the recommended care plan for ulcers, pylori infection, varices or liver disease.