Dark Vomit: Causes and Concerns in Gastroenterology

Suspected hematemesis?

Hello, Dr.
Lin.
About six months ago, I experienced vomiting that included a dark brownish (slightly reddish) substance that was stringy and in significant quantity.
I did not notice the color of any other watery vomit.
That morning, I only drank a bottle of milk tea and smoked two cigarettes.
Recently, a friend of mine vomited blood due to gastric bleeding, and he mentioned that the color of his vomit looked similar to mine (I took a photo when I vomited), which made me a bit concerned.
However, this happened six months ago, and I have not experienced any discomfort since then.
I did vomit once or twice in the meantime, but I did not pay special attention to it.
Doctor, could this indicate any disease? Could it be related to smoking or the milk tea? Since it has been six months and I have not felt unwell, I have overlooked it.

Xiao Jia, 20~29 year old female. Ask Date: 2016/07/02

Dr. Lin Minghui reply Gastroenterology and Hepatology

1.
There is a possibility of upper gastrointestinal bleeding.
2.
Common causes of gastrointestinal bleeding include peptic ulcers (gastric ulcers, duodenal ulcers), gastritis (due to medications, diet, or stress), mucosal tears at the gastroesophageal junction, cirrhosis, and bleeding from esophageal and gastric varices.
3.
Consuming irritating foods or alcohol may lead to dry heaving or vomiting; in severe cases, vomiting food can injure the mucosa at the gastroesophageal junction, causing tears and resulting in hematemesis.
Smoking and sugary foods can affect the pressure at the gastroesophageal junction.
It is advisable for individuals prone to gastrointestinal discomfort to limit alcohol intake, reduce smoking, and avoid irritating and spicy foods.
Wishing you good health.

Reply Date: 2016/07/02

More Info

Dark vomit can be a concerning symptom, especially when it resembles coffee grounds or has a dark red hue. This coloration typically indicates the presence of blood that has been partially digested, which can occur due to bleeding in the upper gastrointestinal (GI) tract, such as the esophagus, stomach, or the first part of the small intestine (duodenum). The fact that you experienced this symptom about six months ago and have not had any further issues or discomfort since then is reassuring, but it does not completely eliminate the need for caution.

There are several potential causes for dark vomit, including:
1. Gastric Ulcers: These are sores that develop on the lining of the stomach and can bleed, leading to dark vomit. Stress, certain medications (like NSAIDs), and excessive alcohol consumption can contribute to the development of ulcers.

2. Esophageal Varices: These are swollen veins in the esophagus that can rupture and bleed, often seen in individuals with liver disease.
3. Gastritis: Inflammation of the stomach lining can also lead to bleeding and dark vomit.

4. Mallory-Weiss Tear: This is a tear in the esophagus caused by severe vomiting, which can lead to bleeding.

5. Cancer: Though less common, tumors in the stomach or esophagus can cause bleeding.

Regarding your specific situation, the fact that you consumed a milk tea and smoked cigarettes before the episode could potentially contribute to gastric irritation or gastritis, which might lead to bleeding. However, the absence of any further symptoms over the past six months is a positive sign. It is important to note that smoking can exacerbate many gastrointestinal issues, including ulcers and reflux disease, and should be avoided for overall health.

Given your history of dark vomit, it would be prudent to consult a healthcare professional for a thorough evaluation, especially if you experience any recurrence of symptoms. They may recommend diagnostic tests such as an upper endoscopy (EGD) to visually inspect the upper GI tract and identify any potential sources of bleeding.

In summary, while your lack of symptoms over the past six months is encouraging, the initial episode of dark vomit warrants attention. It is always better to err on the side of caution when it comes to gastrointestinal bleeding. If you have any concerns or if symptoms reappear, do not hesitate to seek medical advice. Regular check-ups and being mindful of your lifestyle choices, such as smoking and diet, can help maintain your gastrointestinal health.

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