Coffee ground vomiting is a term for dark-colored vomit containing blood. Generally associated with ulcers, tears, and tumors within the digestive system, treatment is dependent on the underlying cause. Individuals experiencing this symptom may be treated with medication. Rarely, blood transfusion or surgery may be necessary if the vomiting and bleeding is severe.
Peptic ulcers are the most common cause for coffee ground vomit. Resulting from excessive acid production within the digestive tract, peptic ulcers erode tissues, causing ulcers to form. This particular type of vomit is considered a severe symptom. If left untreated, there is a risk of significant blood loss.
This symptom can also be caused by a Mallory-Weiss tear, which is a perforation within the digestive system. Tears may occur in the esophagus or upper digestive tract, causing it to bleed. Individuals with a Mallory-Weiss tear will often produce dark vomit due to the excessive internal bleeding.
In some cases, coffee ground vomiting can be a sign of a stomach tumor. Some forms of stomach cancer can interfere with mucus production within the stomach’s lining, leaving the tissue vulnerable to inflammation. Extensive inflammation causes bleeding, and if it is excessive, the individual may expel the blood when vomiting.
The cause of this type of vomiting is usually discovered with imaging tests. X-ray and endoscopic technology are most commonly used to determine the source of bleeding. Blood analysis may also be conducted to check for markers that indicate an infection or other abnormalities. If imaging and laboratory tests prove inconclusive, exploratory surgery may be performed.
Once the cause for the vomiting is discovered, medications are usually given to heal any ulcerated tissue and ease inflammation. Drugs designed to inhibit stomach acid production and neutralize existing acid are commonly prescribed for peptic ulcers. If a Mallory-Weiss tear is found, the individual is given an acid-suppressing drug to allow the tear time to heal on its own. For individuals with stomach cancer, similar drugs may be given in combination with their existing, anticancer treatment regimen.
Alcoholism, Helicobacter pylori infection, and polyps are among several risk factors for conditions associated with coffee ground vomiting. Individuals with a history of certain conditions, including stomach cancer, are considered at greatest risk for this problem. Regardless of the cause, expelling blood when vomiting is considered a serious situation requiring prompt medical attention.
What Else Can Cause Coffee Ground Vomiting?
Some causes of bloody vomit are mild, such as swallowing blood due to a nose bleed or severe cough. As mentioned above, the common sources of internal bleeding and coffee ground vomit are ulcers, tears, or tumors. However, many other problems can cause blood in vomit.
Gastritis is a general term for inflammation of the stomach lining. Gastritis can cause the stomach tissue to erode, leading to ulcers, tears, and bleeding. The complications can cause coffee-ground-looking blood in vomit. This inflammation can have many causes, including:
- Bacterial infections, especially H. pylori
- Excessive use of drugs or alcohol
- Excessive use of NSAID pain relievers such as aspirin or ibuprofen (Advil)
- Autoimmune problems
- Cancer and chemotherapy
- Other diseases, including HIV/AIDS, Crohn’s disease, and parasites
Other symptoms of gastritis may include stomach pain, nausea, and indigestion. Treatment for gastritis will depend on the cause. Treatment may consist of antacids and other medications.
Heartburn and Acid Reflux
Almost everyone gets heartburn and acid reflux from time to time, but some factors may cause chronic reflux, leading to bloody vomit. Chronic reflux is called GERD or gastroesophageal reflux disease. Long-term acid reflux may be caused by:
- Medications, including NSAIDs
- A hiatal hernia, where a hernia in the stomach disrupts food intake
- Food intolerance
Those suffering from acid reflux or GERD may also experience bloating, coughing, a sour taste in the mouth, and bad breath. Treatment may include diet modification, antacids, and proton pump inhibitors (PPIs) such as omeprazole and lansoprazole.
Alcohol-Related Liver Disease
Alcohol-related liver disease, or ARLD, is caused by long-term excessive drinking of alcohol. The condition has three stages: alcoholic fatty liver disease, alcoholic hepatitis, and cirrhosis. One serious complication of alcoholic hepatitis and especially cirrhosis is portal hypertension.
Portal hypertension occurs when blood pressure within the liver and surrounding intestines increases to the point that blood vessels in this area may burst, leading to internal bleeding. In some cases, this bleeding may be slower and long-term, causing anemia. In other cases, the bleeding may be spontaneous and heavy and, as a result, force the patient to vomit blood.
The best treatment for the early stages of ARLD is to abstain from alcohol. For later stages, some steroids or anti-inflammatory medications may help reduce inflammation in the liver.
After a certain point of ARLD, the only option is a liver transplant. Unfortunately, alcoholics are unlikely transplant candidates. In addition, the risk of ARLD is higher in women and those who are obese, have hepatitis C, or have a genetic predisposition to alcohol problems.
As mentioned above, stomach cancer may lead to stomach bleeding and bloody vomit. In addition, esophageal cancer may cause bloody vomit as well.
Esophageal cancer is cancer of the tissue within the esophagus, which is the tube that food and drink go through to get to the stomach. Symptoms include acid reflux and a chronic cough, which may lead to internal bleeding.
People with a history of extensive tobacco or alcohol use are at a greater risk for esophageal cancer. Treatment depends largely on the specific type of esophageal cancer, its stage, and where it is in the esophagus. Surgery may be an option if the cancer is caught early. Other options include chemotherapy, radiation, immunotherapy, or medications.
Hemophilia is a rare, usually genetic condition in which the blood cannot clot properly. A mutation on the X chromosome that results in fewer clotting elements in the blood causes this disorder. This mutation causes the blood to take longer to clot. Hemophilia mainly affects men, although women may be carriers without symptoms.
Hemophilia may cause ulcers and gastrointestinal bleeding, causing vomit to contain blood. Other symptoms of hemophilia include frequent spontaneous nosebleeds, bleeding gums, bleeding within joints and muscles, and other internal bleeding. The treatment for hemophilia is regular injections of clotting medication.
Some chemical compounds and poisons may cause gastrointestinal hemorrhaging. These may include:
- Superwarfarin, a type of rodent poison that is an anticoagulant
- Paraquat, an herbicide that damages the lining of the mouth, throat, and stomach and causes gastrointestinal distress
- Arsenic, a naturally occurring heavy metal that destroys red blood cells and can cause gastritis and ulcers
Treatment is dependent on the type of poison, how much was ingested, and how much time has passed.
When to See a Doctor
If you are vomiting blood without an obvious cause, you should go to the ER or call your doctor immediately. This is especially true if you vomit blood after an injury, which could be a sign of internal bleeding.