Although not all situations are the result of a major medical problem, this is difficult to know without a medical evaluation. Seek immediate medical attention.

Call your doctor or go to the emergency room if vomiting of blood occurs -- this requires immediate medical evaluation.

• Time pattern
  • When did this begin?
  • Has it ever occurred before?
  • Did it occur after retching or vomiting?
• Quality
  • How much blood was in the vomit?
  • Was the vomit entirely blood?
  • Was the blood bright red, dark red, or black?
  • Were there clots?
• Aggravating factors
  • Has there been a recent nosebleed?
  • Has there been recent vigorous vomiting?
  • Has there been a recent episode of gastroenteritis (nausea, vomiting, abdominal pain)?
  • Has there been a recent episode of coughing?
• Other
  • What other symptoms are also present?
  • Is there bleeding from the nose, rectum, or elsewhere?
  • Is there abdominal pain?
  • Is there blood in the stools or black stools?
  • Is there weakness or fatigue?
  • Is there coughing or coughing up of blood?
• Additional important information
  • What medications are being taken?
  • Is the patient a drinker of alcohol or smoker?
  • Have there been any recent injuries to the nose, mouth, or abdomen?
  • Have there been any recent surgical procedures?
  • Have there been any recent dental procedures such as tooth extractions?
  • Is there a history of bulimia or self-induced vomiting?
  • Is there a history of ulcers, esophageal varices, or liver problems?
  • Has the patient ever turned yellow (jaundice)?
  • Is there a history of problems with blood clotting?

Diagnostic tests that may be performed include:

• Endoscopy (EGD)
• X-rays
• Nasogastric tube (nose-to-stomach tube) placement to check for blood
• Blood work, such as a CBC (blood count), blood clotting values, and liver function tests