Vomiting blood is a condition when there is blood in the vomit. Vomiting itself is the release of stomach contents. When a person vomits blood, the vomit can consist of stomach contents and blood, or it can also consist only of blood.
Vomiting blood or hematemesis is not the same as coughing up blood . Vomiting blood is the release of blood from the stomach, while coughing up blood is the release of blood from the lungs or lower respiratory tract. Therefore, coughing up blood due to TB cannot be called vomiting blood.
Causes of Vomiting Blood
Vomiting blood can be caused by many things, including:
- Inflammation of the esophagus (esophagitis) that causes ulcers
- The rupture of esophageal varices , which are enlarged blood vessels in the esophagus
- The rupture of gastric varices
- Rupture of an artery blood vessel that protrudes from the stomach wall ( Dieulafoy's lesion )
- Rupture of the esophagus wall ( Mallory-Weiss syndrome )
- Inflammation of the lining of the stomach (gastritis)
- Gastric ulcer and GERD disease
- Inflammation of the duodenum (duodenitis )
- Duodenal ulcer ( duodenal ulcer )
- Severe injury to the stomach area
- Tumor or cancer of the stomach, esophagus, or pancreas
Meanwhile, vomiting blood in children can be caused by:
- Congenital disorders
- Disorders in the blood clotting process
- Swallowing large amounts of nosebleeds
- Swallowing foreign objects
- Vitamin K deficiency
Risk factors for vomiting blood
There are many factors that can put a person at risk of vomiting blood, including:
- Taking certain medicines, such as blood thinners or NSAIDs , in the long term
- Suffering from acute liver failure
- Suffering from a disease with vomiting symptoms that are prolonged or of strong intensity
- Suffering from liver disease related to alcohol , cirrhosis , or portal vein hypertension
- Suffering from chronic pancreatitis
- Suffering from a stomach infection caused by Helicobacter pylori bacteria
- Suffering from blood disorders, such as thrombocytopenia, leukemia, hemophilia , or anemia
- Swallowing poisonous substances, such as arsenic or corrosive acids, which can damage the walls of the digestive organs
- Experiencing prolonged heavy stress
Symptoms of Vomiting Blood
Usually, the blood that is vomited comes from the upper digestive tract. Meanwhile, the color of the vomited blood depends on the source of the bleeding and its severity.
Blood that is black in color or like coffee grounds has usually been mixed with stomach acid for a long time before being vomited. Meanwhile, bright red blood is usually the result of bleeding that has just occurred and can come from the esophagus or stomach.
There are several symptoms that can appear along with vomiting blood. These symptoms include:
- Uncomfortable feeling in the stomach
- Stomach pain
- Black stools ( melena )
If the blood vomited is more than 500 cc (± 2 drinking glasses), vomiting blood can cause anemia or even shock . Anemia can be recognized by the appearance of the following complaints:
- The skin looks pale and cold
- The heart beats faster
- Dizziness, dizziness, or headache
Meanwhile, vomiting blood that triggers the appearance of shock can be recognized by the following symptoms and signs:
- Pale skin
- Hands and feet feel cold and wet
- Dizziness while standing
- Breathing becomes short and rapid
- Decreased consciousness
When should you go to the doctor?
Immediately check yourself with a doctor if you experience vomiting blood. If vomiting blood is red, in large amounts, or causes symptoms of shock as above, immediately ask for help to be taken to the IGD or the nearest doctor.
Diagnosis of Vomiting Blood
Vomiting blood is generally a symptom of a condition. To diagnose the cause of vomiting blood, the doctor will first ask and answer questions with the patient about the characteristics of vomiting blood and the history of illness or injury.
However, when the patient comes with a decreased level of consciousness or even loss of consciousness, the doctor will immediately check the patient's breathing rate, blood pressure, pulse, and body temperature.
The doctor will also do a question and answer session with the person who brought the patient to the hospital. The examination aims to determine the initial treatment in order to stabilize the patient's condition. The initial treatment given can be in the form of giving an infusion of liquid or oxygen.
When the patient's condition is stable, the doctor will also perform a supporting examination to ascertain the cause of the vomiting of blood. Some types of supporting tests that can be done are:
- Scanning with CT scan , X-ray photo, USG , or MRI, to detect abnormal tissue growth or digestive organ damage that can cause bleeding
- Endoscopy , to directly determine the source of bleeding in the digestive tract
- Biopsy, to determine the possibility of bleeding caused by infection, inflammation, or cancer
- Complete blood test , to detect blood abnormalities and estimate the amount of reduced blood
- Coagulation test, to find out if the bleeding is caused by a blood clotting disorder
Blood Vomiting Treatment
The treatment of vomiting blood depends on how much blood is lost, the cause of vomiting blood, and complications that appear. The following are some methods that doctors can use to treat vomiting blood:
1. Fluid infusion
This method aims to restore fluid lost due to bleeding and overcome or prevent the onset of shock due to loss of body fluid. If the bleeding is profuse, a blood transfusion may be needed. Fluid infusions can be given while waiting for blood transfusions that may not yet be available.
2. Blood transfusion
Blood transfusions , such as transfusions of red blood cells, platelets, or other clotting factors, are performed to replace blood lost due to vomiting blood or to stop bleeding. A blood transfusion is not always needed, depending on the amount of blood lost.
In addition to finding out the source of bleeding, endoscopy can also be used to control small bleeding that continues to occur. Endoscopy is performed as soon as possible in patients experiencing shock symptoms or at least before 24 hours in patients not experiencing shock symptoms.
Treatment of blood vomiting with surgery is done to control the heavy bleeding that is still going on. This procedure is generally performed when bleeding cannot be treated with endoscopy, for example due to a tear in the stomach or duodenum.
The type of medicine given to control the vomiting of blood depends on the cause. PPI drugs, such as omeprazole , are given to keep the acid (pH) of the stomach from being too acidic and further injuring the stomach or esophagus.
Other drugs that can also be given to deal with vomiting blood include drugs to lower blood pressure in the portal vein, drugs that coat the stomach wall, and anti-nausea drugs.
Complications of Vomiting Blood
Vomiting blood that is not treated immediately can increase the risk of the sufferer experiencing complications, such as:
- Difficulty breathing because blood enters the respiratory tract (aspiration) and accumulates in the lungs
- Suffocation due to blood clots blocking the respiratory tract
- Anemia due to excessive bleeding
- Shock due to lack of blood
Be aware, not everyone who vomits blood must experience aspiration. This condition is more likely to occur in the elderly, stroke sufferers , swallowing disorders and alcohol addiction.
Prevention of Vomiting Blood
Some efforts that can be made to prevent vomiting blood are:
- Avoid consuming foods and drinks that cause stomach acid to rise , such as those with high acid levels, spicy, high fat, or alcohol.
- Maintain a regular eating pattern and schedule, especially if you suffer from gastritis, GERD, gastric ulcer, or duodenal ulcer.
- Check with your doctor regularly if you use medicines, such as blood thinners or NSAIDs, in the long term.
- Do relaxation techniques to manage stress.