What causes and treatment options are available for hematemesis?

Symptom Database

Hematemesis, also known as vomiting blood, is a medical condition that can be alarming and potentially life-threatening. It occurs when there is bleeding in the upper gastrointestinal tract, which includes the esophagus, stomach, and the first part of the small intestine. In this article, we will explore the causes, symptoms, and treatment options available for hematemesis.

What is Hematemesis?

Hematemesis is a condition characterized by the presence of blood in vomit. The blood can range in color from bright red to dark, resembling coffee grounds. It is important to note that hematemesis is different from hemoptysis, which is the coughing up of blood from the respiratory tract.

Causes of Hematemesis

There are several potential causes of hematemesis, including:

  • Gastrointestinal ulcers: Peptic ulcers, which are open sores that develop on the lining of the stomach or the upper part of the small intestine, can cause bleeding and lead to hematemesis.
  • Esophageal varices: These are enlarged veins in the lower part of the esophagus that can rupture and cause bleeding.
  • Mallory-Weiss tear: This is a tear in the lining of the esophagus, usually caused by severe vomiting or retching, which can result in hematemesis.
  • Gastritis: Inflammation of the stomach lining can lead to bleeding and vomiting of blood.
  • Gastric cancer: In rare cases, hematemesis can be a symptom of stomach cancer.

Symptoms of Hematemesis

In addition to the presence of blood in vomit, individuals with hematemesis may experience other symptoms, such as:

  • Nausea and vomiting
  • Abdominal pain or discomfort
  • Black, tarry stools (indicating the presence of digested blood)
  • Weakness or fatigue
  • Lightheadedness or fainting

Hematemesis Treatment

The treatment for hematemesis depends on the underlying cause and the severity of the bleeding. It is crucial to seek immediate medical attention if you or someone you know experiences hematemesis, as it can be a sign of a serious condition.

Initial Assessment and Stabilization

When a person presents with hematemesis, the healthcare provider will first assess their vital signs and stabilize their condition. This may involve administering intravenous fluids, blood transfusions, or medications to control bleeding.


Endoscopy is a common procedure used to diagnose and treat the underlying cause of hematemesis. It involves inserting a flexible tube with a camera into the esophagus, stomach, and small intestine to visualize any abnormalities or sources of bleeding. During the procedure, the healthcare provider may also perform interventions to stop the bleeding, such as cauterization or band ligation.


In some cases, medications may be prescribed to reduce stomach acid production, promote healing of ulcers, or prevent further bleeding. These medications may include proton pump inhibitors, H2 blockers, or antibiotics to treat Helicobacter pylori infection, a common cause of gastric ulcers.


If the bleeding cannot be controlled through endoscopy or medications, surgery may be necessary. Surgical interventions may involve removing the source of bleeding, repairing damaged blood vessels, or removing cancerous tumors.

Prevention and Self-Care

While it may not always be possible to prevent hematemesis, there are steps individuals can take to reduce their risk:

  • Avoid excessive alcohol consumption, as it can contribute to the development of gastric ulcers and liver disease.
  • Quit smoking, as smoking increases the risk of developing gastric ulcers and esophageal cancer.
  • Manage stress levels, as chronic stress can contribute to the development of gastric ulcers.
  • Follow a healthy diet that includes fruits, vegetables, and whole grains, as these foods can help maintain a healthy gastrointestinal tract.
  • Take prescribed medications as directed and discuss any concerns or side effects with a healthcare provider.

In conclusion, hematemesis is a condition characterized by the presence of blood in vomit. It can be caused by various factors, including gastrointestinal ulcers, esophageal varices, and gastritis. Prompt medical attention is essential for proper diagnosis and treatment. Treatment options may include endoscopy, medications, or surgery, depending on the underlying cause and severity of the bleeding. By following preventive measures and seeking timely medical care, individuals can reduce their risk of experiencing hematemesis and its associated complications.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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