Blood in Vomit: Gastrointestinal Issues Explained - Gastroenterology and Hepatology

Dry heaving with blood. I have seen both a gastroenterologist and a pulmonologist. Personally, I believe it is a gastrointestinal issue?

Hello doctors, I am a master's student.
Recently, I have been feeling nauseous after drinking coffee and tea, but it stopped when I stopped drinking them.
However, I have been experiencing a cough with phlegm, and sometimes when I cough it up, there are streaks of blood in it.
My condition seems to be that when I expel something from my body, there are streaks of blood (about once a week, I notice slight blood streaks in my phlegm, which are not very noticeable, and it goes away after coughing up once or twice).
Additionally, I often feel a sensation of air rising when I sleep with my mouth open, and just now when I felt nauseous, I immediately vomited and noticed more blood streaks.
I also have a feeling of bloating in my gastrointestinal tract.
I would like to ask what might be wrong with me and what disease I might have?

Xiao Zhang, 20~29 year old female. Ask Date: 2016/11/06

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, if you are concerned, you can have an X-ray and endoscopy at Changhua Hospital.
We care about your health.
Chen Shidian.

Reply Date: 2016/11/06

More Info

It sounds like you are experiencing a concerning combination of symptoms, including the presence of blood in your sputum, gastrointestinal discomfort, and a sensation of bloating. Given your description, it is essential to approach this situation with caution and seek medical attention promptly.

The presence of blood in your sputum (hemoptysis) can arise from various causes, some of which may be serious. It is crucial to differentiate whether the blood is originating from the respiratory tract or the gastrointestinal tract. In your case, since you mentioned that the blood appears when you cough up phlegm, it is more likely related to a respiratory issue. Possible causes of hemoptysis include:
1. Bronchitis: Inflammation of the bronchial tubes can lead to coughing and the production of blood-streaked sputum, especially if there is significant coughing involved.

2. Infections: Conditions such as pneumonia or tuberculosis can cause hemoptysis. If you have been experiencing a persistent cough, it would be wise to consider these possibilities.

3. Pulmonary Embolism: A blood clot in the lungs can lead to sudden onset of hemoptysis, along with chest pain and difficulty breathing. This is a medical emergency.

4. Lung Cancer: Although less common, especially in younger individuals, it is still a possibility that should not be overlooked, particularly if there are other risk factors present.

On the gastrointestinal side, your symptoms of bloating and discomfort could be indicative of several conditions, including:
1. Gastroesophageal Reflux Disease (GERD): This condition can cause a sensation of bloating and discomfort, particularly if you experience acid reflux, which might also lead to coughing and potential irritation of the throat.

2. Peptic Ulcers: Ulcers in the stomach or duodenum can lead to gastrointestinal bleeding, which may sometimes be coughed up if the blood is swallowed and then expelled.

3. Gastritis: Inflammation of the stomach lining can cause discomfort and may lead to bleeding in some cases.

Given your symptoms, it is essential to monitor the following:
- Frequency and Amount of Blood: If you notice an increase in the amount of blood or if it becomes more prominent, seek immediate medical attention.

- Associated Symptoms: Pay attention to any additional symptoms such as fever, weight loss, or changes in appetite, which could indicate a more serious underlying condition.

- Duration of Symptoms: If your symptoms persist or worsen over the next few days, it is crucial to consult a healthcare provider.

In terms of follow-up, it is advisable to schedule an appointment with a healthcare professional who can perform a thorough evaluation. This may include imaging studies (like a chest X-ray or CT scan) and possibly a bronchoscopy to visualize the airways directly. Additionally, a gastroenterologist may be needed to assess any gastrointestinal issues.

In summary, while your symptoms may not indicate a severe condition, the presence of blood—whether in sputum or related to gastrointestinal discomfort—should always be taken seriously. Early intervention can lead to better outcomes, so do not hesitate to seek medical advice.

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