Haematemesis (Vomiting Blood) Treatment in Delhi, India

The colour and texture of the blood might differ in each cause. The blood colour can vary from brilliant crimson to the look of coffee dregs appearance. The symptoms are as follows:

• Dizziness
• Confusion
• Pale skin
• Tachycardia
• Blurry vision
• Weakness
• Chest breathing
• Low urine
• Jaundice

If vomit has blood, it can be a sign of bleeding in the oesophagus, stomach, or initial section of the duodenum.

Below are some of the most likely reasons for vomit having blood. Do not use the list to self-diagnose; always consult a doctor.

• Stomach ulcer: A gastric or duodenal ulcer is the most plausible reason for vomiting blood & experiencing a scorching or nagging sensation around the stomach. It occurs when stomach inflammation damages the artery, due to which bleeding occurs.
• Esophageal varices:  In oesophageal varices, veins of the lower section of the food pipe get enlarged. Enlarged veins bleed without any pain. They are usually triggered by alcoholic liver disease. If a doctor believes the cause of vomiting blood is due to esophageal varices, then it is best to get hospitalised quickly.
• Severe gastro-oesophageal reflux disease: In gastroesophageal reflux disease, acid from the stomach runs back into the oesophagus. This acid reflux might damage the esophageal lining and cause bleeding if a person has acute GORD.
• Esophageal tear: Retching over an extended period might damage the membrane of the oesophagus, resulting in blood.
• Swallowed blood: Blood can be swallowed in some conditions, like after a violent nosebleed. Blood may appear in a person's poop due to these diseases, giving it a dark, tar-like appearance.

Rare Causes of Haematemesis

Rare causes are as follows:

• Ingesting a poisonous substance, such as arsenic or caustic acid.
• A blood disorder, like thrombocytopenia, leukaemia, anaemia or haemophilia.
• Upper or middle oesophagus cancer or Gastric cancer - these cancers are sporadic.

A doctor may ask questions related to symptoms to diagnose and treat haematemesis. The doctor may arrange an imaging test to examine internal organs. The following are some of the most widely used imaging tests performed for these processes:

•  CT scan
•  X-ray
•  Endoscopy
•  MRI
•  Ultrasound

The physician may order an upper GI endoscopy to check for bleeding in the food pipe and stomach. Once a patient is anaesthetized, the doctor then conducts the endoscopy. The doctor will insert a flexible tube attached to a light and camera called an endoscope into the mouth, abdomen, & small intestine. The endoscope helps the doctor see the contents of the abdomen and inspect the inside for potential sources of bleeding.

To check blood count, the doctor may order a blood test—this aids in determining the volume of blood loss. A biopsy may be performed to see if an acute, infectious, or malignant source causes the bleeding. Based on the blood test results, the doctor may recommend further testing.

The type of treatment for blood vomiting will depend on the cause. Based on the cause doctor may give the following treatment.

Medications

It may be prescribed to lessen the quantity of acid produced by the abdomen. If a person is suffering from ulceration that induces vomiting blood, this could help. A person may also require medication to stop blood from flowing to an incision.

Tests

• Bleeding is generally treated with endoscopy. To heal a tear, the health professional may apply heat or use a clamp to hold tissues together so it can cure.
• The doctor may order a blood transfusion if a person loses a considerable amount of blood.
• Angiography is a procedure used to detect and block arterial bleeding. In this method, arteries are injected with contrast liquid, and with the help of x-rays, a person's blood flow is obtained.

Surgery 

If severe bleeding or other therapies have failed, surgery may be required. A tear in the stomach or intestine wall may require surgery to repair. The doctor may also order surgery in case of blockage or tumour.

Haematemesis can result in various health problems, based on the source.

• Shock: GI bleeds that occur suddenly and abruptly can result in a lack of blood supply to the rest of the body, triggering organ damage & organ failure. Shock can intensify without therapy, resulting in permanent injury or death. Dangerously low blood pressure, blue lips & fingernails, chest pain, altered mental state, dizziness, anxiety, pale complexion, low urine output, rapid yet weak pulse, chest breathing, & unconsciousness are all signs & symptoms of shock.
• Anaemia: It is one of the side effects of heavy bleeding, and a shortage of red blood cells causes it. It happens when there is a large amount of blood loss in a short period.
• Hypovolemia: When a person loses blood due to a severe GI bleed, their heart may struggle to circulate sufficient blood throughout the body. Symptoms include sweating excessively, disorientation, agitation, reduced urine output, weakness, pale complexion, fast breathing, & unconsciousness.

Several factors increase the risk of haematemesis, such as:

• Smoking
• Alcohol can damage and dissolve the stomach's mucus lining and influence the amount of gastric acid, leading to gastric ulcers.
• Overeating spicy food
• Advanced cirrhosis

Reviewed by Dr. Vikas Singla, Director & Head – Gastroenterology (Pancreatic-Biliary, Luminal Gastroenterology & Endoscopy Division) Gastroenterology, Hepatology & Endoscopy, on 29-Dec-2022.