Black vomit, also known as coffee-ground emesis, is dark brown or black vomit with a granular, lumpy texture, resembling coffee grounds. This appearance indicates the presence of old, coagulated blood in the gastrointestinal tract. The dark color results from blood being partially digested by stomach acid. This is a serious medical symptom requiring immediate attention.
Understanding the Causes
The black, granular appearance of vomit occurs when blood from the upper gastrointestinal (GI) tract interacts with stomach acid. The iron in hemoglobin oxidizes upon exposure to gastric acid, causing the blood to turn dark. This indicates bleeding in the esophagus, stomach, or duodenum.
Common medical conditions leading to black vomit include peptic ulcers, which are sores in the stomach or duodenum lining. Bleeding from these ulcers, often caused by bacterial infections or certain medications, can result in coffee-ground emesis. Gastritis, an inflammation of the stomach lining, can also lead to bleeding. Esophageal varices, enlarged veins in the esophagus, can bleed, especially in individuals with liver disease. These varices develop when blocked blood flow to the liver increases vein pressure, making them prone to rupture.
Mallory-Weiss tears, tears in the lower esophageal tissue, are another potential source. These often result from forceful vomiting or coughing that increases abdominal pressure. While less common, certain foods like dark berries or chocolate, and some medications such as iron supplements or bismuth subsalicylate, can mimic black vomit. However, a medical evaluation is always necessary to rule out serious internal bleeding.
Immediate Actions to Take
Black vomit signals internal bleeding and requires immediate medical attention. Call emergency services or go to the nearest emergency room promptly.
Internal bleeding can quickly become life-threatening if not addressed. Waiting can lead to severe complications like shock, organ damage, or death due to significant blood loss. Even if bleeding appears to slow or stop, the underlying cause requires urgent diagnosis and treatment.
Medical Diagnosis and Treatment
Healthcare providers will conduct a thorough evaluation to determine the cause of black vomit. This begins with a physical examination and a review of your medical history. Blood tests, such as a complete blood count, assess for anemia and the extent of blood loss.
The most common diagnostic procedure is an upper endoscopy, also known as an esophagogastroduodenoscopy (EGD). During an EGD, a thin, flexible tube with a camera is inserted through the mouth to visualize the esophagus, stomach, and duodenum, allowing doctors to locate the bleeding source. In many cases, treatment can be performed during the endoscopy.
Treatment depends on the specific cause and severity of the bleeding. Endoscopic interventions may include cauterization, clipping, or banding to stop bleeding. Medications to reduce stomach acid, such as proton pump inhibitors, or antibiotics to treat infections like H. pylori that cause ulcers, may be prescribed. Supportive care, including intravenous fluids or blood transfusions, might be necessary if significant blood loss occurs.