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Hematemesis
Hematemesis, or vomiting blood, is a serious sign of bleeding in the upper gastrointestinal tract. Whether appearing bright red or resembling coffee grounds, it demands prompt evaluation and treatment. At GastroDoxs Houston, Dr. Scott offers expert diagnosis and care options.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Common Causes and Risk Factors
Stomach ulcers from H. pylori infection or NSAID use
Gastritis (inflammation of the stomach lining)
Esophageal varices due to chronic liver disease
Mallory-Weiss tears from forceful or repeated vomiting
Heavy alcohol consumption or tobacco use
Chronic acid reflux (GERD) irritating the upper GI tract
Signs and Symptoms
Vomiting bright red blood or dark “coffee-ground” material
He asks about the onset and amount of bleeding, prior GI symptoms (like ulcers or reflux), alcohol use, NSAID use and any liver disease history. A focused physical exam looks for abdominal tenderness, signs of anemia, or stigmata of chronic liver disease.
Blood Tests
Complete blood count checks for anemia. Coagulation studies (PT/INR) and liver function tests help evaluate bleeding risk and rule out underlying liver dysfunction. H. pylori testing may be ordered if an ulcer is suspected.
Endoscopic Evaluation
Upper endoscopy (EGD) directly visualizes the esophagus, stomach, and duodenum.
During EGD, he can identify ulcers, varices, Mallory-Weiss tears or gastritis.
Therapeutic interventions (clips, banding or injections) can be performed on the spot if active bleeding is seen.
Imaging Studies
CT angiography to localize active bleeding if endoscopy is inconclusive.
Abdominal ultrasound to assess for cirrhosis and portal hypertension.
Advanced Diagnostics (if needed)
In rare or refractory cases, interventional radiology angiography identifies and embolizes bleeding vessels. A capsule endoscopy or tagged red blood cell scan may be used for intermittent bleeding that wasn't captured on initial studies.
Treatment
Our Team offers a full range of care for hematemesis.
1. Diet and Lifestyle Changes
Switch to a low-acid, bland diet
Eat smaller meals more often
Avoid alcohol, caffeine, and spicy foods
2. Medications
Proton pump inhibitors (PPIs) to reduce gastric acid
Antibiotics if H. pylori infection is detected
H2 blockers or antacids for mild cases
IV fluids or blood transfusion if significant blood loss occurs
3. Minimally Invasive or Advanced Treatments
Endoscopic banding or clips to stop active bleeding
Epinephrine injections during endoscopy
Balloon tamponade for severe variceal bleeding
Surgery or interventional radiology when necessary
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
What is hematemesis?
Hematemesis refers to vomiting blood or dark, coffee-ground-like material from your esophagus, stomach, or upper small intestine.
What is the ICD-10 code for hematemesis?
The ICD-10 code for hematemesis is K92.0.
What causes hematemesis with nausea?
Common causes include stomach ulcers (often from H. pylori or NSAIDs), gastritis, esophageal varices, or forceful vomiting leading to Mallory-Weiss tears.
Is hematemesis an emergency?
Yes. Vomiting blood or feeling lightheaded are warning signs. You should seek immediate medical attention.
Can diet help prevent hematemesis?
Yes. A low-acid, bland diet with smaller, more frequent meals-while avoiding alcohol, caffeine, spicy foods, and NSAIDs-can reduce your risk.
How does Dr. Scott find the cause of hematemesis?
Dr. Scott conducts a physical exam, blood tests, imaging (CT scan or ultrasound), and endoscopy to locate and diagnose the bleeding source.
What conditions can mimic hematemesis?
Melena (black, tar-like stools), swallowed blood from nosebleeds, and bleeding from ulcers, varices, gastritis, or esophageal tears may resemble hematemesis.
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