Summary about Disease
Hematemesis refers to the vomiting of blood. The blood can be bright red, dark red, or look like coffee grounds, depending on whether it has been partially digested. It indicates bleeding in the upper gastrointestinal (GI) tract, which includes the esophagus, stomach, and duodenum. It is a symptom of an underlying condition, not a disease in itself.
Symptoms
The primary symptom is vomiting blood. Other symptoms that may accompany hematemesis, depending on the underlying cause, include:
Abdominal pain
Dizziness or lightheadedness
Weakness
Pale skin
Rapid heartbeat
Shortness of breath
Black, tarry stools (melena) - indicating digested blood passing through the digestive system.
Causes
Hematemesis is a sign of bleeding in the upper GI tract. Common causes include:
Peptic ulcers (stomach or duodenal ulcers)
Esophageal varices (enlarged veins in the esophagus, often due to liver disease)
Gastritis (inflammation of the stomach lining)
Esophagitis (inflammation of the esophagus)
Mallory-Weiss tear (tear in the lining of the esophagus due to forceful vomiting)
Tumors (esophageal or stomach cancer)
Blood clotting disorders
Certain medications (e.g., NSAIDs)
Swallowed blood from a nosebleed or mouth injury (pseudohematemesis)
Medicine Used
The medication used to treat hematemesis depends entirely on the underlying cause. Some possibilities include:
Acid-reducing medications: Proton pump inhibitors (PPIs) or H2 receptor antagonists for ulcers or gastritis.
Antibiotics: To treat H. pylori infection if it is the cause of the ulcer.
Vasoconstrictors: To reduce bleeding from esophageal varices.
Blood transfusions: To replace lost blood.
Medications to control nausea and vomiting: Anti-emetics.
Octreotide: To reduce blood flow to the upper GI tract in certain situations.
Is Communicable
Hematemesis itself is not communicable. However, if the underlying cause is an infectious agent, such as Helicobacter pylori which can cause ulcers, then that underlying cause *is* communicable.
Precautions
Seek immediate medical attention: Hematemesis is a medical emergency.
Avoid taking NSAIDs: If prone to GI bleeding.
Manage underlying conditions: Such as liver disease.
Avoid alcohol and smoking: As they can irritate the GI tract.
Practice good hygiene: If the cause is H. pylori, to prevent its spread (though this is more relevant to preventing ulcers initially, not treating hematemesis directly).
How long does an outbreak last?
There is no "outbreak" in the sense of a contagious disease. The duration of hematemesis depends entirely on the underlying cause and how quickly it is diagnosed and treated. Bleeding can be a one-time event or recurring.
How is it diagnosed?
Physical exam: Assessing vital signs and looking for signs of blood loss.
Blood tests: Complete blood count (CBC) to assess blood loss, liver function tests, coagulation studies.
Endoscopy: Esophagogastroduodenoscopy (EGD) - inserting a flexible tube with a camera into the esophagus, stomach, and duodenum to visualize the source of bleeding.
Stool test: To check for occult blood (blood not visible to the naked eye).
Imaging studies: In some cases, CT scans or angiography may be used.
Timeline of Symptoms
The timeline of symptoms varies depending on the cause and severity of the bleeding.
Sudden onset: May occur with a Mallory-Weiss tear or sudden rupture of varices.
Gradual onset: May occur with a slowly bleeding ulcer or tumor.
Associated symptoms: Abdominal pain, lightheadedness, and weakness may precede or accompany the vomiting of blood. Melena (black, tarry stools) may appear hours to days later.
Important Considerations
Hematemesis is a symptom, not a disease. Finding the underlying cause is crucial.
The amount of blood vomited does not always correlate with the severity of the underlying condition. Small amounts of blood can still indicate a serious problem.
Prompt diagnosis and treatment are essential to prevent complications such as shock, anemia, and even death.
Patients with hematemesis should be evaluated by a medical professional as soon as possible.