Hematemesis is simply known as vomiting blood. When there is blood in vomit, it usually connotes of a serious medical problem, as it may indicate that there is bleeding along the upper gastrointestinal (GI) tract. The upper gastrointestinal tract is comprised of the mouth, esophagus, stomach and the duodenum, first part of the small intestine.
Apart from the examination, a detailed history will be taken by the physician. There are several tests that can be done to determine the cause of hematemesis, which include an endoscopy (insertion of a thin, flexible tube with a camera at the tip through the upper GI tract), rectal examination and blood tests.
Hematemesis, or vomiting blood, should not be confused by hemoptysis, or coughing blood. Although they are both expelled from the mouth, hemoptysis comes from the respiratory tract and will have a different consistency from hematemesis.
Hematemesis is considered a medical emergency.
Types of Hematemesis
There are different types of hematemesis based on its appearance (color specifically) and amount. The following are the different types:
- Large quantity of bright red blood
- Typically indicative of a fast but rapid bleeding in the upper GI tract
- Coffee ground blood (dark brown to red color)
- Typically indicative of slow bleeding
- Change to coffee ground color signifies that the blood has come in contact with the stomach acid
- If not given immediate medical attention, may progress to heavy bleeding
- Streaks of red blood
- Typically indicative that it has blended with food
- If paired with melena (dark, sticky stool that contains blood that was digested to some degree)
- Typically indicative of gastrointestinal hemorrhage
Causes of Hematemesis
There is a large variety of causes of hematemesis, thus it is important to pinpoint the exact organ causing the bleeding so it can narrow down the potential causes. Some of the potential causes of hematemesis based on the organ affected include:
Esophagus:
- Esophagitis (inflammation of the esophagus)
- Gastroesophageal reflux (esophageal irritation due to stomach acid reflux)
- Esophageal cancer
- Esophageal varices
- Mallory-Weiss syndrome: tear in the esophageal or stomach lining
Stomach:
- Gastritis (inflammation of the stomach lining)
- Gastric (stomach) ulcer
- Stomach cancer
- Stomach varices
- Mallory-Weiss syndrome: tear in the esophageal or stomach lining
Duodenum:
- Duodenitis (inflammation of the duodenum lining)
- Duodenal cancer
Others:
- Swallowed blood from epistaxis (commonly known as nosebleed)
- Ingested poison
- Blood disorders
- Injury of any organ in the upper GI tract
First Aid Management for Hematemesis
Hematemesis is considered a medical emergency, thus at first signs of presence of blood in the vomit, seek medical attention immediately. The primary goal of treatment is to stop the bleeding. The earlier the medical condition is detected, the better the prognosis. The following treatments can be done in cases of loss of large amounts of blood and fluids:
- Intravenous (IV) fluids may be required
- Surgery
- Some causes may be managed by medications.
Understanding hematemesis can help when taking First Aid Courses. Hematemesis, or presence of blood in vomit, usually connotes of a serious medical problem, as it may indicate that there is bleeding along the gastrointestinal tract. Hematemesis is considered a medical emergency.
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