Coffee ground vomitus is a type of vomit that looks like coffee grounds. Coffee ground vomitus owes its appearance to the presence of old blood in the vomit.

The amount of time the blood remains in the gastrointestinal (GI) tract before appearing in the vomit will determine its color and shade. A more extended period will result in a darker color, which may be dark red, black, or brown.

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Anyone who vomits blood should seek medical attention immediately as it is a serious condition. If possible, bring a sample of the vomit to the doctor and note the time and quantity of the vomit, as well as any possible causes.

In this article, we look at the causes, symptoms, and treatment of coffee ground vomitus.

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Causes

Person holding stomach due to coffee ground vomitus
Causes of coffee ground vomitus can include gastric ulcers and cirrhosis.

There are many potential causes of coffee ground vomitus, including:

  • gastric ulcers
  • esophageal varices, when swollen veins in the esophagus burst and bleed
  • gastritis, irritation of the stomach lining
  • cirrhosis, severe scarring on the liver and reduced liver function
  • Ebola
  • hemophilia B, an inherited blood clotting disorder that causes easy bruising and bleeding
  • cancer of the esophagus, or food pipe

These conditions all require medical attention and treatment.

Symptoms

Anyone who vomits blood or a substance that resembles coffee grounds should seek immediate medical attention. If the person is unable to get to the emergency room, they should call for an ambulance.

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Other symptoms that may indicate an emergency situation include:

  • chest pain
  • dizziness
  • pale skin
  • severe pain in the abdomen
  • feeling of lightheadedness
  • bright red blood in the vomit
  • large clots in the vomit
  • fainting

The other symptoms that may accompany coffee ground vomitus will vary depending on the underlying condition.

Diagnosis

Coffee ground vomitus usually indicates bleeding in the GI tract. If this occurs, a person should always seek a diagnosis from a doctor.

To diagnose the cause of coffee ground vomitus or any contributing factors, a doctor will ask the person if they are:

  • experiencing any other symptoms
  • taking any medications
  • dealing with any other medical conditions

The doctor will then perform a medical exam to check the person. Following this, they will order one or more tests to determine the exact cause of the bleeding.

Most people will need blood tests and a chest X-ray to examine the area. In addition to this, a person may receive one or more of the following tests:

  • Fecal occult blood test. This is to check for possible blood in the stool.
  • Barium study. This examination uses an X-ray and a dye called barium to look for problem areas within the GI tract.
  • Endoscopy. A doctor will insert a long thin tube with a light and camera down a person’s throat to examine the stomach, esophagus, and upper small intestine. They may also take a tissue sample.
  • Colonoscopy. This involves passing a long thin tube with a light and camera through a person’s rectum to check the lower portion of the GI tract.
  • Gastric occult blood test. This is to check for blood in a person’s vomit.
  • Liver function tests. These check for problems in a person’s liver.

Once they have the results of the tests, the doctor can make a more accurate diagnosis and develop a treatment plan that will address the underlying condition causing the coffee ground vomitus.

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Treatment

The treatment for coffee ground vomitus will vary greatly depending on the underlying cause. A doctor will need to determine what is causing the blood to appear in the vomit before making any recommendations on treatment.

If an ulcer or gastritis is causing a person’s coffee ground vomitus, a doctor may treat it with the following:

  • antibiotics to clear up the Helicobacter pylori infection that causes ulcers
  • acid-reducing medications to reduce the stomach acid and allow the stomach to heal
  • antacids to provide pain relief and neutralize existing stomach acids
  • medications to protect the stomach lining

If Ebola is the cause of the coffee ground vomitus, a doctor may recommend:

  • antiviral medications
  • intravenous fluids and electrolytes
  • medication to reduce vomiting
  • medication for fever
  • treatment of any other infections that may occur simultaneously

For people with upper GI cancer, a doctor will tailor treatment to the type and stage of cancer. Treatment for upper GI cancer may include:

Replacement therapy is the usual treatment for a person whose coffee ground vomitus is due to hemophilia B. In replacement therapy, the person receives intravenous infusions of the missing clotting factors. These clotting factors help to stop bleeding in the upper GI tract.

A doctor will prescribe beta-blockers to someone whose coffee ground vomitus results from esophageal varices. This medication will reduce blood pressure in the bleeding vein. The doctor may also recommend rubber band litigation, which will involve using elastic bands to tie off bleeding veins to stop the bleeding.

If cirrhosis is the cause, a doctor may suggest:

  • intravenous antibiotics
  • nitrates or beta-blockers
  • banding procedures to control bleeding in the esophagus
  • hemodialysis

A doctor may also recommend that people with cirrhosis stop drinking alcohol and follow a diet low in protein.

Outlook

Anyone who experiences coffee ground vomitus should seek medical attention as soon as possible. If they have additional symptoms, such as fresh blood or large clots, the person should seek emergency medical attention.

A doctor will need to diagnose the underlying cause of coffee ground vomitus before recommending treatment. The severity of the underlying condition will determine how long it will take for a person to recover and see a reduction in symptoms.