Have you been throwing up black or brown vomit? You may be experiencing upper gastrointestinal bleeding, which is a medical emergency if there are related symptoms like abdominal pain or bloody stools. Other less serious causes of dark brown vomit can arise from eating certain foods or liquids, or a side-effect from medication. Read below for more information on causes and treatment options for vomiting black or brown contents.
Black or brown vomit? you may be throwing up blood
As unpleasant as it is, vomiting is an important bodily function. It is your best defense mechanism against food poisoning and the ingestion of harmful substances, as well as your body’s way of eliminating toxins.
In addition to its protective role, vomiting can also be associated with serious underlying conditions, especially if your vomit appears black or brown. It may not be initially apparent, or even something that will ever cross your mind until it happens; however, vomit that is black or brown can often be blood.
This symptom is an emergency
Vomiting blood, or hematemesis, is a medical emergency that requires immediate attention . It is important to note that small flecks or streaks of blood that you may see on your toothbrush or in your mouth are usually not considered hematemesis.
Common accompanying symptoms of black or brown vomit
If you are truly vomiting blood, you may also experience symptoms such as:
- Upper abdominal pain or discomfort
- Black or tarry-looking stools: Also known as melena
- Ascites, an accumulation of fluid in the abdomen
- Appetite changes
Symptoms of excessive bleeding
In situations of excessive bleeding, you may also experience:
Seek prompt medical attention if you experience any of the above symptoms.
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Causes of black or brown vomit
Causes of hematemesis can involve any part of the gastrointestinal tract; however, problems with the organs and components of the upper gastrointestinal tract are most commonly associated with hematemesis. These causes are varied but can most easily be grouped into categories such as inflammatory, vascular, trauma, and cancer-related.
Conditions such as esophagitis, gastritis, duodenitis - all refer to some kind of inflammation in that organ and/or injury to the mucosal lining. There are many different causes of inflammation including:
- Infection: There are various bacteria and viruses that can infect and cause inflammation of the organs of the upper abdominal tract. Certain bacteria such as H. pylori can cause the formation of ulcers that are often associated with hematemesis.
- Medication: There are many medications that can cause irritation and inflammation of the mucosa of the upper gastrointestinal organs. Non-steroidal anti-inflammatory drugs (NSAIDs) are a common culprit that can also cause ulcers and hematemesis.
- Environmental: Environmental toxins such as smoking and alcohol can result in significant irritation and inflammation of the esophagus and other upper abdominal organs.
- Acid: Although the stomach requires acid for properly digesting food, sometimes the acid can be caustic and damaging to the mucosal lining of the upper organs, especially if the mucosal lining is injured by any of the above causes.
Vascular causes of black or brown vomit may include:
- Pressure: Certain conditions can cause high blood pressure in the portal vein, a large vein that brings blood from the lower intestine to the liver. The increased pressure in this vein can spread or transfer to the upper veins of the esophagus and stomach that easily bleed and cause hematemesis.
- Malformation: Malformations in the blood vessels of the upper gastrointestinal tract are a common cause of bleeding that can result in bloody vomit. This type of malformation is known as angiodysplasia.
- Lesional: Lesions in the blood vessels of the upper gastrointestinal tract can cause erosion and injury that results in hematemesis.
Trauma-related causes of black or brown vomit may include:
- Direct: Trauma to the upper gastrointestinal tract is not limited to direct accidents (such as motor vehicle accidents) which can cause significant internal bleeding. Trauma can also be characterized as continued or repetitive irritation and/or laceration of the inner linings of the upper abdominal organs. For example, forceful retching in conditions such as bulimia can result in tears along the esophagus that can manifest as hematemesis. Ingestion of foreign objects that become lodged in the esophagus can also cause trauma that results in bleeding and vomiting.
- Iatrogenic: The word iatrogenic refers to an illness or condition caused by medical examination or treatment. In the case of hematemesis, invasive procedures such as endoscopy and others that directly access the esophagus and upper abdominal organs can result in black or brown vomit.
In general, any cancer is the result of cells dividing and growing uncontrollably. Sometimes there is a genetic mutation in DNA or a specific protein or failure in an important checkpoint that results in this unchecked growth. These abnormal cells can accumulate to form a growth or tumor, that can grow and invade other parts of the body. Tumors in any organ of the upper gastrointestinal tract from the stomach to the esophagus to the pancreas can result in hematemesis.
This list does not constitute medical advice and may not accurately represent what you have.
Upper gastrointestinal bleeding
The digestive, or gastrointestinal (GI), tract includes the esophagus, stomach, small intestine, large intestine, rectum, and anus. Upper GI bleeding is a medical emergency involving internal bleeding from the esophagus, stomach, or the small intestine.
Top Symptoms: fatigue, being severely ill, abdominal cramps (stomach cramps), lightheadedness, rectal bleeding
Symptoms that always occur with upper gastrointestinal bleeding: vomiting (old) blood or passing tarry stools, being severely ill
Urgency: Emergency medical service
Acute variceal hemorrhage
Acute variceal hemorrhage is a condition that can occur secondary to (as a result of) liver disease. Blood vessels bringing blood from the digestive tract back to the heart which course through the esophagus (a muscular tube that carries food from the mouth to the stomach) become dilated. In acute variceal hemorrhage, these vessels burst, resulting in internal bleeding.
Top Symptoms: being severely ill, abdominal pain (stomach ache), vomiting, constipation, lightheadedness
Symptoms that always occur with acute variceal hemorrhage: being severely ill, vomiting (old) blood or passing tarry stools
Urgency: Emergency medical service
A peptic ulcer is a sore in the lining of the stomach or the first part of your small intestine (the duodenum), which causes pain following meals or on an empty stomach.
Top Symptoms: fatigue, nausea, loss of appetite, moderate abdominal pain, abdominal cramps (stomach cramps)
Symptoms that never occur with stomach ulcer: pain in the lower left abdomen
Urgency: Primary care doctor
A neoplasm, or tumor, can be benign/non-cancerous, or it can be malignant/cancer. Since benign stomach tumors are mostly harmless polyps that often go unnoticed, the term stomach neoplasm usually refers to stomach cancer. Because stomach cancer usually goes undetected until an advanced st...
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When and how to seek treatment for throwing up blood
When it is an emergency
If you begin vomiting large quantities of blood or black or brown vomit, or your vomit persists or worsens and you cannot keep food or liquid down, or you are in severe pain, you should seek medical attention immediately.
Treatment for immediate and large volume hematemesis involves procedures that work to primarily stop the bleeding. These include but are not limited to the following procedures:
- Embolization: Injecting particles directly into blood vessels to stop bleeding.
- Ligation: This uses special bands to specifically treat bleeding vessels, especially in the esophagus.
- Clipping: This procedure uses a solid clip to close the defective area.
- Surgery: Reserved for uncontrollable bleeding
When to see a doctor
If you have experienced black or brown vomit, you should schedule an appointment promptly. Many of the inflammatory causes of hematemesis are more chronic and treatment involves healing and preventing ulcers and areas of inflammation. Many of these medications are also targeted at controlling damaging acid production. Your physician can discuss these medications and treatments with you and determine the best course of action based on your symptoms and medical history.
- Antibiotics: Your healthcare provider will prescribe the appropriate antibiotic for your symptoms. These may include amoxicillin, clarithromycin and/or levofloxacin.
- Acid reducers: Also known as proton pump inhibitors (PPIs) these medications reduce stomach acid by blocking cells that produce acid in the stomach.
- Acid blockers: Also known as histamine blockers, these medications reduce the amount of acid your stomach makes at baseline.
- Antacids: These medications neutralize existing stomach acid and can provide very quick relief.
You can also practice the following lifestyle remedies to help prevent the development of hematemesis:
- Quit smoking
- Limit/avoid alcohol
- Reduce use of NSAIDs: Non-steroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve). Talk to your doctor about other methods of pain management.
- Eat a healthy diet: Made up of fruits and vegetables, lean meats and proteins, whole grains, and healthy fats. Drinking plenty of water is also essential to good overall health.
FAQs about black or brown vomit
If it is blood, why does the vomit look black or brown?
As the blood travels through the gastrointestinal tract to the outside of the body, the red blood cells undergo breakdown and the hemoglobin releases iron atoms that are now exposed to oxidation — meaning the oxygen from the air oxidizes the iron resulting in a darker color.
Is black or brown vomit a medical emergency?
Yes, black or brown vomit can signal internal bleeding that requires immediate medical attention.
What dietary changes can help with peptic ulcers?
Diets composed of various fruits and vegetables high in vitamins A and C are very helpful in both healing and preventing the formation of peptic ulcers.
I have chronic pain. How can I limit my use of NSAIDs?
Talk to your physician about alternative pain medications that are not in the NSAID category. Acetaminophens, such as Tylenol, are not in this category and may help control your pain without causing irritation and bleeding that results in hematemesis.
Are medications that help control acid in the upper gastrointestinal tract available over-the-counter?
Yes, there are many proton pump inhibitors (PPIs), acid blockers and stomach neutralizers available over-the-counter. Examples include esomeprazole (Nexium), ranitidine (Zantac) and Tums. However, always speak with your physician first before starting any new medications on your own.
Dark vomit symptom checker statistics
People who have experienced black or brown vomit have also experienced:
- 18% Abdominal Pain (Stomach Ache)
- 12% Vomiting
- 8% Nausea
People who have experienced black or brown vomit were most often matched with:
- 38% Upper Gastrointestinal Bleeding
- 38% Acute Variceal Hemorrhage
- 22% Stomach Ulcer
People who have experienced black or brown vomit had symptoms persist for:
- 65% Less than a day
- 21% Less than a week
- 5% Over a month
Source: Aggregated and anonymized results from Buoy Assistant.
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- Peptic ulcer. Mayo Clinic. Published July 19, 2018. Mayo Clinic Link