Vomiting blood (hematemesis) means blood coming up with vomit. It can look like bright red blood or dark, coffee‑ground material. This page gives general information on possible causes, signs that require urgent attention, and which specialists may be involved in evaluation. It is not a substitute for professional assessment.
Blood in vomit ranges from fresh bright red to brown or coffee‑ground‑like material. Bright red blood usually indicates a more recent bleed; darker material suggests partially digested blood. Appearance alone does not identify the source—clinical assessment and tests are needed to determine the cause.
Causes often arise from the upper gastrointestinal tract, such as stomach ulcers, severe gastritis, esophageal varices, or tears in the esophagus. Less common sources include lower GI bleeding that is then expelled, respiratory tract bleeding, or blood from the mouth or teeth that is swallowed then vomited. Bleeding tendencies from blood disorders or medications that affect clotting can also contribute.
Vomiting blood can be life‑threatening in some situations. Seek immediate emergency care if there is large or repeated vomiting of blood, fainting or loss of consciousness, dizziness, very fast or weak pulse, difficulty breathing, or noticeable paleness. These signs may indicate significant blood loss or hemodynamic instability and need urgent professional evaluation.
Initial evaluation is often in emergency care or by primary care. Specialists involved can include gastroenterology (endoscopic assessment and management of upper GI bleeding), general surgery (when surgical treatment is needed), hematology (for bleeding disorders), and infectious diseases or pulmonary specialists if another source is suspected. Imaging, blood tests, and endoscopy are commonly used in diagnosis.
Pay attention to the severity of symptoms and seek emergency care when red flags are present. During medical assessment, clinicians will take a history, perform an exam, and order tests such as blood counts, coagulation studies, imaging, or endoscopy as needed. Avoid starting or changing medications on your own before discussing with a health professional; follow instructions from the treating team.
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