Causes Of Hematemesis

Hematemesis, or vomiting blood, is a serious condition that should always be considered a medical emergency even though minor issues such as a nosebleed can sometimes cause it. This is because hematemesis may be a sign of internal bleeding requiring immediate attention. Depending on the cause of hematemesis and the severity, the regurgitated blood can be bright red, dark red, or even brown. Vomiting blood can be very frightening and isn't always life-threatening, but it may be a sign of one of the following conditions that should be treated as soon as possible.

Mallory-Weiss Syndrome

Mallory-Weiss syndrome refers to bleeding tears in the mucosa where the esophagus and stomach are joined. This condition is usually caused by severe and violent retching or vomiting, often as a result of bulimia, alcoholism, or, less commonly, the abuse nonsteroidal anti-inflammatory medication. The hallmark symptom of the syndrome is hematemesis, but it can also cause melena, or old blood in the stool. The bleeding and vomiting of blood stops after one or two days for most patients.

This condition is similar to Boerhaave syndrome, except it only involves the submucosa and mucosa layers, not the muscular layer. It usually affects mean and individual over sixty years old. The most notable exception to this is hyperemesis gravidarum, a severe form of morning sickness that causes severe vomiting during pregnancy and may cause a tear in the mucosa as well.

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Gastritis Or Gastroenteritis

Vomiting blood can sometimes be the result of gastritis or gastroenteritis, two conditions that occur when the stomach lining is inflamed. Gastritis refers to inflammation, erosion, or irritation of the stomach lining that is chronic or acute. Gastroenteritis, on the other hand, affects both the lining of the intestines and stomach.

Gastritis may be caused by anything from medications like acetylsalicylic acid or stress to excessive alcohol consumption or chronic vomiting. It has also been linked to H. pylori bacteria, which cause ulcers and certain infections. Symptoms of gastroenteritis vary from patient to patient, but commonly include abdominal pain and bloating, nausea, indigestion, a burning sensation in the stomach at night, hiccups, and vomiting with or without blood. Hematemesis caused by gastritis usually resembles coffee grounds.

Gastroenteritis, also known as stomach flu, is caused by a bacterial or viral infection that irritates the stomach and intestines. Gastroenteritis may cause nausea, headache, fever, stomach pain, diarrhea, and vomiting. Vomiting blood may happen after severe vomiting that causes a tear in the esophagus.

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Hemorrhagic Fever

Viral hemorrhagic fever refers to a collection of infectious diseases that prevent blood from clotting while damaging the walls of blood vessels to make them leak. This collection includes yellow fever, Lassa fever, Marburg fever, dengue fever, and Ebola. These diseases are most common in tropical areas and cause internal bleeding that may be somewhat minor to life-threatening.

While the symptoms depend on the virus, common symptoms include fatigue, a high fever, muscle and joint aches, weakness, and dizziness. Bleeding may occur under the skin, in organs, and from the eyes, ears, and mouth. Vomiting blood may also be seen.

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Bleeding Ulcers

A peptic or stomach ulcer occurs when stomach acid causes damage to the lining of the digestive tract. Most ulcers are caused by H. pylori, a bacterial infection in the stomach that weakens the mucous coating of the stomach and allows stomach acid to reach the more sensitive lining beneath it. These open sores can cause burning pain in the stomach, a feeling of bloating, heartburn, nausea, and intolerance to fatty foods. In about twenty-five percent of patients, ulcers cause no symptoms at all.

While usually not serious, ulcers can perforate the gut or bleed very heavily. Bleeding ulcers can cause anemia, shortness of breath, lightheadedness, and fatigue. A heavily bleeding ulcer may also cause black, sticky stool and bloody vomit. When a bleeding ulcer is responsible for hematemesis, the vomit usually has the color and consistency of coffee grounds.

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Stomach Or Esophageal Tumors

One of the most serious causes of hematemesis is a tumor of the stomach or esophagus. Stomach or esophageal tumors are typically not caught early because the symptoms are vague and include heartburn, abdominal discomfort, nausea, constipation, diarrhea, and bloating after meals.

When stomach or esophageal cancer becomes more advanced, it can cause blood in the stool and hematemesis. These tumors tend to be fragile and bleed easily, and they are usually detected when they cause bleeding in the gastrointestinal tract. Significant bleeding into the stomach or esophagus can cause vomiting of blood which may look partially digested or similar to dark coffee grounds.