Black Vomit: 13 Causes, Diagnosis, When to see a doctor

Black vomit is a scary symptom and can be caused if there is blood in the vomit due to any cause. This condition of presence of blood in the vomit is called hematemesis. In Hematemesis, the color of the vomit or vomiting can have many different colors like brown, black or red.

There are many other abnormal symptoms associated with Black vomit, and you need to be aware of them. Some such symptoms are nausea, feeling dizzy, diarrhea, lightheadedness, etc.

We will discuss everything about it in this article. Black vomit is never a normal condition. You should consult a physician and get yourself evaluated for the cause and get it treated.

Sources of Black vomit:

black vomit
Black vomit
Image source: firstshock.com

Black Vomit is mostly bleeding from the upper gastrointestinal tract or upper GI which includes the following:

  • Esophagus
  • Stomach
  • Small intestine parts like Duodenum
  • Pancreatic problems can also cause black vomit

Why does Vomit appear Black:

Just now we discussed the sources of Black vomit. But, do you know why the bleeding from gastrointestinal tract appears like Black vomit. Let us understand that first. It is because the upper GI bleeding from any source passes through the stomach.

During this phase, the enzymes of the stomach act on the blood and turn it into Coffee ground color or Black color. This is the reason we see Black vomit when we have Upper GI bleeding.

Black vomit Causes:

In most of the cases, patients don’t describe the vomit precisely as Black vomit, but they describe the vomiting or vomit to be brown, red or coffee ground vomit. Let us discuss the causes of such kind of Black vomit below:

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Peptic ulcers:

Peptic ulcers can develop over the stomach lining or duodenal lining. Ulcers are the erosion in the mucosal lining of the organ. Peptic ulcers are erosion in the stomach or duodenal lining. When they are very deep, they can cause erosion of the blood vessels supplying these areas leading to upper GI bleeding and ultimately Black vomit.

Mallory Weiss tear:

It is a tear in the mucosal membrane in the junction of the esophagus and the stomach. This tear occurs when you vomit forcefully. It can be due to Severe vomiting in Alcoholics or Forceful vomiting in people doing it wantedly like in Bulimia Nervosa, an eating disorder. Mallory Weiss tear is also one of the most common causes of Black vomit.

Neoplasm:

If you have a tumour, either benign or malignant of the organs of the upper gastrointestinal tract, you will have bleeding from them leading to Black vomit. But, you will be experiencing many other abnormal symptoms based on the organ involved. For example, Dysphagia or difficulty eating, abnormal weight loss, etc.

Acute liver failure:

Acute liver failure is the sudden dysfunction of the liver due to various liver disorders. The liver plays a vital role in the metabolism of various clotting factors which control bleeding. In acute liver failure, there is coagulopathy or abnormality of clotting factors, which leads to Upper GI bleeding and then Black vomit.

Cirrhosis:

Cirrhosis is the development of fibrosis in the liver, and it can occur due to many different causes. In this problem, there is the development of portal hypertension, increased pressure in the portal venous system. This can lead to the formation of Esophageal varices which can bleed and lead to Black vomit or be throwing up black stuff.

Trauma to organs:

When you have an injury or trauma to the internal organs of the upper gastrointestinal tract like Stomach, esophagus, pancreas, duodenum, etc. due to accidents, medical procedures, etc., you will have bleeding from these organs leading to Black vomit.

Pancreatic cancer:

Pancreatic cancer is a very dangerous condition. In less than 3% of people who have pancreatic cancer, there can be upper gastrointestinal bleeding which can manifest as Black vomit. But, pancreatic cancer is an infrequent cause of bleeding and Black vomit.

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Duodenal inflammation:

If a person has Duodenal inflammation or Duodenitis, he can experience erosion of blood vessels supplying the duodenum leading to bleeding.

Kidney disorders:

Bleeding in the upper Gastrointestinal tract occurs ten times more than the general public in people with kidney disorders. In such people, bleeding can be seen from skin surfaces and also mucosal surfaces in the internal organs of the body.

Gastritis:

Gastritis is the inflammation of the stomach lining. In this condition, if the inflammation is severe, the blood vessels supplying the stomach can erode leading to bleed and Black vomit.

Coagulation defects or disorders:

Coagulation disorders like Clotting factors deficiencies, Hemophilia, Von Willebrand disease, etc. can lead to bleeding in the upper GI, leading to Black vomit. But, they also cause bleeding in other body parts like tendons, muscles, skin rashes due to bleeding, Epistaxis or nose bleeding, uncontrollable bleeding from injuries, etc.

Rupture of blood vessels:

Sometimes we tend to have a cough due to viral or bacterial infections. If we continue repeatedly coughing with pressure, it can rupture the blood vessels leading to bleeding and ultimately Black vomit.

Drug-induced:

Drugs like NSAIDS or Non-steroidal anti-inflammatory drugs which are very commonly used for the treatment of various type of pain can cause gastritis and also peptic ulcers. These, in turn, can lead to bleeding from the gastrointestinal tract which appears like Black vomit.

Black vomit Diagnosis:

When you visit your physician to diagnose the cause of Black vomit, he will take a detailed History to diagnose why you are throwing up black stuff. He will ask about symptoms relating to the stomach, esophagus, liver and pancreatic disorders. He may also ask if you have bleeding from any other part of the body to suspect coagulation disorders.

Then he will perform a detailed physical examination to rule out which organ or part of the body is involved. Later based on the findings of history and physical exam, he will order diagnostic tests of the organ involved.

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Most commonly Upper GI endoscopy is done to rule out lesions like a Peptic ulcer, Mallory Weiss tear, etc. in the Upper Gastrointestinal tract. Sometimes he might also order Blood tests like Coagulation profile to rule out Coagulation defects based on the need.

Black vomit Treatment:

Treatment of Black vomit depends on the cause of the bleeding. Let us see some examples:

  • If the cause of the Black vomit is gastritis, you will have to take drugs like PPI or proton pump inhibitors to reduce gastritis.
  • If the cause is Liver disorders, you will have to receive treatment to correct them.
  • If cause if Mallory Weiss tear, you have to take treatment to let the tear heal, and you should also avoid alcohol. If you have Bulimia nervosa, you need to consult a psychiatrist and take treatment.
  • If you are having a tumor or neoplasm of any sort, you might need chemotherapy, radiotherapy, surgery, etc.

When to see a doctor:

Black vomit itself is not normal in most of the cases. It needs to be evaluated for sure by an experienced physician. You need to keep in mind the following symptoms which can accompany Black vomit, as you need to consult your physician soon if you notice them. Some such symptoms are:

  • Nausea
  • Diarrhea
  • Feeling Dizzy or Giddy
  • Fainting
  • Fast breathing or Tachypnea
  • Blurred vision
  • Feeling confused or disoriented
  • Decreased urination
  • Cold skin or feeling very cold

Conclusion:

In most of the people, Black vomit is not normal and needs evaluation by a physician. But, in some people, it can also be caused if you consume any black colored food and have vomiting after that.

If you are sure that you have not consumed any black colored food, and you have any other abnormal symptom, ensure to get checked up by a physician without delay.

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