Throwing up blood: A video for patients

Author: Nabin Sapkota, MD

Throwing up blood is a medical emergency. If you are actually throwing up blood right now do not even wait to finish this video and get down to the nearest emergency department right away call nine one one if you have to. Otherwise this video is for patients wanting to know more about throwing up blood. I will not be using any medical terms as I am not talking to my fellow health- care providers. I am talking directly to you-- the patient. Let's see how you throw up blood.

This is our mouth. It connects down to the food pipe which goes down to the stomach. The stomach then connects to the upper part of the intestine. Bleeding in any of these places can result in throwing up blood. So when you through up blood, how do you know where it is coming from.

The simple answer is you simply don't. Well, you will find some people on the internet uh... Saying that you would tell it by the color of the blood but that is simply not true. Any bleeding in any these places is bright red when it just starts to bleed. As the blood sits in the stomach and gets digested, it turns darker. We can divide throwing up blood into three different categories based on what is likely to happen. The first category uh..

Is a severe life-threatening bleeding that can kill you within a few hours if not treated property. The example of this type of bleeding is uh... Variceal bleed uh... Variceal bleed is a kind of bleeding that happens in the uh.. Food pipe. People with bad liver disease may get this kind of bleed.

Throwing up blood: A video for patients

Varices are engorged blood vessels uh... That are present in in the food pipe. They are in engorged in patients uhÉwho have liver damage mostly because of alcohol but can also happen in other types of liver diseases. Uh... In these patients the damaged liver causes back flow uh..

Causes a blockage in in the normal blood flow from the food pipe to the liver uh... Instead the obstructed blood flows backwards into the food pipe. The blood vessels then become distended and uh... When they rupture the bleeding in so fast and large that you can bleed to death within a few hours. If someone has known liver damage, it is the type of bleeding you need to really worry about. The second category of uh... Bleeding is usually self-limited. They bleed a little and mostly stop on their own.

Of coarse, there may be exceptions and even the most benign type of bleed can become life-threatening in certain patients uh at anytime but the most common example of this type of bleeding is a small tear in the food pipe somewhere around here. Uh it can happen after you forcefully vomit many times and cause trauma to your food pipe. It can happen doing hangovers when you get uh very sick and keep throwing up forcefully.

That may cause some tearing of food pipe and can cause throwing up blood but the thing is uh there is no way to tell if this particular kind of bleeding is what's causing you to throw up blood. They can only tell that when they put a scope down your mouth and look inside the food pipe. That third category uh of throwing up blood can go either way uh they can stop on their own or can progress rapidly and can result in death. Bleeding ulcers are good example of this kind of bleeding. Ulcers can happen in the stomach uh or the upper part of the intestine. Uh the kind and amount of bleed depend on what kind of blood vessels is eroded by the ulcer. A small vessel can stop bleeding on his own but a large vessel can keep bleeding untill you you actually run out of blood. Ulcer bleeding can sometimes be so slow that you may not have any throwing up blood.

The blood may quietly go down uh... And actually come out as black tarry stool instead of vomiting blood. Thank you for listening.

You can read more about throwing up blood and other symptoms on the symptoms and diagnosis book website. Thank you very much.

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