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What Is Coffee Ground Vomiting?

By J.M. Willhite
Updated Mar 06, 2024
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When someone mentions coffee ground vomit, they're referring to a specific symptom where vomit appears brown, indicating the presence of blood. The name is apt too, as searchng “coffee ground vomit pictures” reveals images resembling dark coffee grounds. This alarming sign can point to serious gastrointestinal issues. 

According to the National Library of Medicine, such bleeding is often related to gastric ulcers, which affect about 4.5 million people annually in the United States. Treatment hinges on the precise diagnosis, with options ranging from medication to, in severe cases, surgery or blood transfusions. Understanding the implications of coffee ground vomit pictures is crucial for timely medical intervention and appropriate care.

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)
  • Stress
  • 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

Heartburn is an unpleasant feeling caused by stomach acid traveling into the throat. Severe acid reflux can cause gastritis and ulcers, leading to stomach bleeding. 

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:

  • Pregnancy
  • Medications, including NSAIDs
  • A hiatal hernia, where a hernia in the stomach disrupts food intake
  • Smoking
  • Obesity
  • 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.

Esophageal Cancer

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.

FAQ on Coffee Ground Vomiting

What is coffee ground vomiting and what causes it?

Coffee ground vomiting refers to a particular type of vomiting where the vomitus resembles coffee grounds. This appearance is due to the presence of coagulated blood in the vomit, which has been acted upon by gastric acids. The causes can range from gastrointestinal issues such as peptic ulcers, gastritis, or esophageal varices, to more severe conditions like stomach cancer. It's essential to seek medical attention if you experience this symptom, as it indicates bleeding within the gastrointestinal tract.

How is coffee ground vomiting diagnosed?

Diagnosis of coffee ground vomiting typically involves a combination of patient history, physical examination, and diagnostic tests. A doctor may order an endoscopy, which allows for direct visualization of the gastrointestinal tract to identify the source of bleeding. Additionally, laboratory tests such as a complete blood count (CBC) can assess the extent of blood loss and help determine the cause. Imaging studies like CT scans may also be utilized in certain cases.

What are the treatment options for coffee ground vomiting?

Treatment for coffee ground vomiting depends on the underlying cause. For conditions like peptic ulcers, medications that reduce stomach acid and promote healing may be prescribed. In cases of severe bleeding or esophageal varices, endoscopic procedures can be used to stop the bleeding. Surgery may be necessary for more serious conditions like stomach cancer. It's crucial to address the root cause to prevent further episodes and complications.

Can coffee ground vomiting be prevented?

Prevention of coffee ground vomiting involves managing risk factors for gastrointestinal bleeding. This includes avoiding excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), treating Helicobacter pylori infections, limiting alcohol consumption, and controlling chronic conditions like cirrhosis. Regular medical check-ups and prompt treatment of gastrointestinal symptoms can also help prevent the development of conditions that could lead to coffee ground vomiting.

When should someone seek medical attention for coffee ground vomiting?

Medical attention should be sought immediately if someone experiences coffee ground vomiting. This symptom indicates internal bleeding, which can quickly become life-threatening. Additionally, if coffee ground vomiting is accompanied by other symptoms such as dizziness, fainting, severe abdominal pain, or shortness of breath, emergency medical services should be contacted without delay. Timely medical intervention is critical for a positive outcome.

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Discussion Comments

By burcinc — On Mar 07, 2012

@feruze-- Yea, people who have never seen coffee ground emesis before can mistake it to be something else. (Coffee ground emesis is another name for this condition). I've mistaken chocolate remnants to be blood before and the other way around too.

I have two ulcers in my stomach and I've vomited coffee ground like blood a couple of times. My doctor described it to me in detail so that I would always know when it happens and can get treatment before it's too late.

He said that when my stomach bleeds, the blood gets digested by my stomach juices. The iron in the blood is oxidized in this process and turns the blood into a dark substance, what looks like coffee grounds or spots of a blackish-brown dark substances to us.

When I'm in doubt, I still go get checked out. I've been told that if it's not treated in time, my stomach acids could leak out of the ulcers and eat away at the surrounding organs. Doesn't that sound horrible? I always get scared out of my mind when I vomit coffee grounds.

By SteamLouis — On Mar 06, 2012

@feruze-- I'm not an expert but I know that blood in vomit may not always look like coffee grounds. I believe what it looks like depends on the cause and the location of the problem. If blood looks like coffee grounds, it means that there is a problem in the upper gastrointestinal tract (rather than the lower one). But blood might also appear as red or darker colored clots.

My dad experienced this several times due to his chronic cough which tore the lining of his esophagus. But he wasn't vomiting. If the blood shows up in vomit, it's general from an ulcer in the stomach.

And as far as I know, blood in stool is not coffee like at all, but more tar like and almost black in color, not brown. And this is a sign of a lower gastrointestinal disorder.

By bear78 — On Mar 05, 2012

I had a helicobacter pylori infection a couple of years ago and my doctor had told me to come in to the hospital immediately if I vomit blood. He didn't describe to me what blood would look like in such a case though.

Nausea and vomiting was a common occurrence for me at the time because of the infection. The nausea didn't stop until after the entire treatment was over, which was huge amounts of antibiotics for about a month.

One day, I was nauseated and vomited, and saw red things in the vomit, which I took to be blood. I went to the hospital and they asked me if I vomited what looked like ground coffee. I said no, that it was red, not brown. I didn't know until then that blood in vomit or stools takes on a brownish color and has a thick ground coffee-like appearance. What I saw was probably tomato skins, as I had had tomatoes in my salad for lunch that day.

I'm glad that I was wrong and hadn't vomited blood. That would have been pretty scary and I might have had surgery. Now I know that blood is not a red color in such cases.

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