If you're puking and pooping blood, in all likelihood you're experiencing gastrointestinal bleeding. The bleeding itself is not a disease, but rather a symptom of any number of serious illnesses, according to the National Library of Medicine.
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Bleeding can occur at any point along the gastrointestinal (GI) tract, also known as the digestive tract — from the mouth to esophagus, stomach and intestines and all the way down to the rectum. It's often, though not always, visible to the naked eye in either stool or vomit, explains the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). If the bleeding comes on suddenly, usually quite severely, it's called acute. When it's a recurring issue that comes in bouts of varying lengths, it's considered chronic.
According to NIDDK, each year roughly 100,000 Americans are seen at hospitals for GI bleeding, with bleeding in the upper GI tract accounting for the largest share of all digestive tract bleeding cases. (In the Western world, only 20 to 33 percent of GI bleeding cases result from bleeding in the lower GI tract.) Also, men are twice as likely as women to experience upper tract bleeding.
What Bleeding Might Look Like
When blood is visible in the stool, the residue may appear red, black, dark brown or black and tar-like, according to the Mayo Clinic. In vomit, you could see bright red blood, but blood in vomit can also take on the appearance of grains of coffee in both color and texture.
Even if you don't see any blood, Mayo states that there are other telltale symptoms that could indicate that GI bleeding is occurring. These include feeling lightheaded, dizzy or faint or experiencing an onset of either chest pain or abdominal pain.
Why There's Blood in Stool and Vomit
While the list of conditions responsible for GI bleeding is extremely long and varies by degree of severity, one common culprit of rectal bleeding is hemorrhoids, according to Mayo Clinic. Swollen veins located in the anus and lower rectum region, hemorrhoids are incredibly common. In fact roughly 75 percent of American adults struggle with them at one point or another.
Both internal and external hemorrhoids can trigger bleeding, though the internal variety is particularly prone towards generating blood when having a bowel movement. And though they can be painless, the strain and irritation associated with trying to pass stool can lead a hemorrhoid to bleed, Mayo explains.
Read more: Running and Hemorrhoids
Though hemorrhoids are a possibility, it's important that you don't assume this is the cause of blood seen in your toilet bowl. Many other underlying conditions, potential more serious, could be involved. For example, the National Library of Medicine lists peptic ulcers, esophageal tears, diverticulosis, ulcerative colitis, polyps in the colon and Crohn's disease as potential causes of GI bleeding. Cancer of the colon, stomach or esophagus is another possible explanation for why you're spotting blood in either your stool or vomit.
People who throw up a significant amount of blood may have a condition known as hematemesis. According to Mayo, hematemesis typically doesn't result from a nosebleed run-off or overly strenuous coughing. It's more like the result of serious bleeding in the upper GI tract area, due to conditions as varied as peptic ulcers or a torn blood vessel. Anyone vomiting up heavy quantities of blood should seek medical attention right away.
"If there is a large amount of blood in the vomit or in diarrhea, then patients should definitely check in with their doctors," says Andrew Chan, MD, MPH, director of the Gastroenterology Training Program and vice chair of gastroenterology at Massachusetts General Hospital and a professor of medicine at Harvard Medical School in Boston. "And if they feel lightheaded or weak, they should seek immediate medical attention at an ER."
Read more: Can Coffee Cause Bloody or Black Stools?
Testing to diagnose GI bleeding typically involves a screening procedure known as an endoscopy. It involves the insertion of a flexible tube outfitted with a light and camera through either the mouth or the rectum (as with a colonoscopy) to enable your doctor to visualize areas of the GI tract and determine the source of the bleeding.
- Andrew Chan, MD, MPH, director, Gastroenterology Training Program, vice chair, education, gastroenterology, Massachusetts General Hospital, and professor of medicine, Harvard Medical School, Boston.
- National Library of Medicine: "Gastrointestinal Bleeding."
- National Institute of Diabetes and Digestive and Kidney Diseases: "Definitions and Facts of GI Bleeding."
- Mayo Clinic: "Gastrointestinal bleeding."
- Mayo Clinic: “Hemorrhoids.”
- Mayo Clinic: "Vomiting Blood."
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.