Symptoms

  • The symptoms of haematemesis can range from a single small vomit to catastrophic life threatening bleeds.
  • There are multiple causes of haematemesis in people with advanced disease:
    • Coagulopathy
    • NSAID and corticosteroid use
    • Portal hypertension causing varices
    • Tumour bleeding
    • Stress ulcers.

 

Signs

Signs should be sought to confirm the diagnosis from the history.

 

Management

  • Consider and manage the underlying cause (for example tumour, NSAID, coagulopathy)
  • Consider admission where there is a potentially reversible cause
  • Stop anticoagulants, corticosteroids and NSAIDs where possible
  • Commence a proton pump inhibitor
  • Antifibrinolytics can be helpful but can be associated with increased thromboembolic disease
  • Consider giving vitamin K.