Vomiting coffee grounds

Vomiting coffee grounds is a serious symptom of bleeding in the gastrointestinal tract; the patient requires immediate medical attention. Vomit has a characteristic brown, black-brown, coffee-like color due to the presence of hematin hydrochloride , a compound that is formed when hemoglobin reacts with hydrochloric acid.

• What diseases cause vomiting of coffee grounds?
• Vomiting coffee grounds in oncology
• What other symptoms may occur with bleeding in the gastrointestinal tract?
• What to do if you vomit coffee grounds?
• Diagnostic methods
• Treatment methods

The color and appearance of the vomit can indicate the source of bleeding:

• If there is bleeding from the esophageal artery, bright scarlet blood will be present in the vomit.
• If there is bleeding from an esophageal vein, the blood will be darker.
• If the source of bleeding is the stomach, the patient will vomit coffee grounds. However, if there is a lot of blood and little hydrochloric acid is produced in the stomach, the vomit will be mixed and red unchanged blood will be present.

What diseases cause vomiting of coffee grounds?

Vomiting of coffee grounds can occur as a complication of esophagitis (inflammation of the esophageal mucosa), gastritis and gastroduodenitis, ulcers and erosions in the stomach, severe gastroesophageal reflux disease. With cirrhosis of the liver, chronic hepatitis, thrombosis of the portal vein, less often with cardiovascular failure, portal hypertension (increased pressure in the portal vein), varicose veins of the esophagus occur and the risk of bleeding increases.

Mallory-Weiss syndrome is a condition where, with severe repeated vomiting, a rupture of the mucous membrane occurs in the abdominal (located below the diaphragm) part of the esophagus. Most often it occurs in people suffering from alcoholism, especially with alcoholic cirrhosis, when there are varicose veins of the esophagus. Severe overeating and diaphragmatic hernia are identified as predisposing factors.

The risk of bleeding in the gastrointestinal tract increases when taking drugs that reduce blood clotting, nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin, ibuprofen, diclofenac, etc.

Other possible reasons:

• pancreatitis;
• non-alcoholic fatty liver disease;
• autoimmune diseases;
• some infections: Ebola virus, yellow fever;
• Hemophilia B is a congenital disease caused by a deficiency of blood clotting factor IX.

Dyspeptic disorders: nausea, vomiting in children

Nausea in a child, children

Nausea is an unpleasant, painful subjective sensation that precedes or accompanies vomiting. It is usually associated with decreased functional activity of the stomach and changes in the motor function of the duodenum and small intestine. Nausea occurs when intraduodenal pressure increases, and is therefore especially characteristic of diseases of the duodenum: duodenitis, gastroduodenitis, duodenal ulcer. Nausea accompanying vomiting is accompanied by changes in the activity of the autonomic nervous system (especially the parasympathetic): pallor of the skin, increased sweating, excessive salivation, weakness, dizziness, tinnitus, often hypotension and bradycardia.

Vomiting in a child, children

Vomiting is a reflexive act of expelling the contents of the stomach through the mouth. The act of vomiting is controlled by two functionally different centers in the medulla oblongata: the vomiting center and the chemoreceptor trigger zone, which in itself is not capable of mediating the vomiting act, but its activation leads to the sending of effective impulses to the vomiting center located in the medulla oblongata, which in turn causes vomiting Act. Both of these centers are located close to each other and to other centers in the brain stem that regulate vasomotor and autonomic functions. The vomiting center receives afferent signals from the intestines and other organs, from higher cortical centers, especially from the inner ear apparatus, and from the trigger zone.

Vomiting is the final stage of a physiological act involving the sympathetic and autonomic nervous systems, pharynx, gastrointestinal tract and skeletal muscles of the chest and abdominal cavity. The onset of gagging is accompanied by weakness, pallor, sweating, bradycardia and decreased blood pressure. A deep inhalation occurs, the epiglottis descends and the larynx rises, which protects the airways from vomit entering them. In the act of vomiting, an important role is played by the contraction of the diaphragm and the muscles of the anterior abdominal wall, which is accompanied by antiperistaltic contractions of the stomach muscles when the pylorus is closed.

A type of vomiting in children of the first year of life: regurgitation

A type of vomiting in children of the first year of life is regurgitation , which occurs without effort, that is, without tension in the abdominal press. The eruption of gastric contents does not affect the child’s behavior or his mood, regardless of the volume, degree of digestion of food, time elapsed after feeding, and the strength of the eruption.

Regurgitation may be a sign of the onset of an intestinal infection; regurgitation is often observed in healthy children. Regurgitation can be artificially provoked by sudden and irrational movements of the child after eating, motion sickness, or awkward pressure on the epigastric region.

Intestinal vomiting in children

Intestinal vomiting is observed with intestinal obstruction (intussusception, volvulus, tumors, etc.). Vomiting is repeated, persistent, with a fecal odor (intestinal contents), accompanied by retention of feces and gases. It is preceded by cramping pain in the abdomen.

Bloody vomiting in a child, children

Bloody vomiting (hematemesis) most often occurs when a large vessel is damaged due to gastroduodenal erosions and ulcers, esophagitis, stomach tumors, etc.

If vomiting does not occur at the time of bleeding, but after a short period of time, during which the blood mixes with gastric contents (hydrochloric acid), the vomit takes on the color of coffee grounds due to hydrochloric acid hematin. Profuse bloody vomiting after breakfast or in the middle of the night, often with dark red clots, is a symptom of varicose veins of the esophagus and cardia of the stomach. Blood that enters the gastrointestinal tract below the duodenum rarely ends up in the stomach. The admixture of blood in the vomit may be caused by blood sucked by the child in the presence of cracks in the mother's nipple or swallowed during nosebleeds and other bleeding in the upper parts of the nasopharynx.

Vomiting is a protective reaction of the digestive system

Physiologically, vomiting is a protective reaction of the digestive system, freeing the stomach from poor quality food or toxic substances. At the same time, prolonged indomitable vomiting leads to the loss of water and electrolytes by the body, resulting in dehydration and chlorpenic coma with symptoms of alkalosis, and in chronic cases, exhaustion of the body.

Types of vomiting in children

Diseases of almost any system, especially the brain, can be accompanied by vomiting. Depending on the mechanism of occurrence, there are several types of vomiting .

Central (cerebral, nervous) vomiting . Diseases of the nervous system (cerebral edema caused by inflammation, hypoxemia, trauma, acute hydrocephalus, tumors, etc.), which lead to increased intracranial pressure, may be accompanied by vomiting. Damage to the inner ear apparatus and its central connections is also often accompanied by nausea and vomiting. Cerebral vomiting usually develops without connection with food, it is not preceded by nausea, it does not improve the patient’s condition, the vomit is scanty and odorless.

Hematotoxic vomiting occurs with liver and kidney failure, metabolic diseases (galactosemia, acetonemic vomiting, diabetic precoma, etc.), digitalis intoxication, hypervitaminosis D, acute poisoning, etc.

Visceral , or actually reflex, is esophageal, gastric, intestinal vomiting.

Esophageal vomiting (as opposed to true vomiting and regurgitation) is the release of food and liquid that has not reached the stomach, which is observed with congenital esophageal atresia, congenital or acquired esophageal stenosis, diverticula, achalasia. Vomiting occurs immediately after eating; the vomit has no sour odor (does not have contact with gastric juice), is not voluminous, and consists of undigested food.

Gastric vomiting occurs more often against the background of stomach diseases. Vomiting in acute and chronic gastritis, gastroduodenitis, peptic ulcers, intestinal infections and food toxic infections is usually preceded by nausea, which distinguishes it from vomiting caused by irritation of the vomiting center. It is usually associated with food and brings temporary relief to the child. Vomit coming from the stomach is characterized by a sour odor. Remnants of undigested food, mucus, and blood (the color of coffee grounds) are found in the vomit. Vomiting that does not bring relief is characteristic of diseases of the hepatobiliary system and pancreas. An admixture of bile in the vomit is observed in all persistent vomiting, regardless of the reasons that cause it. Vomiting, if persistent and strong, due to high pressure, can lead to rupture of the esophagus or linear ruptures of the mucous membrane of the cardial part of the stomach, which causes gastric bleeding.

Children in the first months of life may vomit like a fountain. This is a typical sign of pyloric stenosis, which is an indication for a more detailed study (ultrasound of the stomach, fluoroscopy with a contrast agent).

Regurgitation is the return of food from the stomach to the oral cavity without the characteristic signs of vomiting. It is often observed with gastroesophageal reflux, with mechanical or functional (achalasia) narrowing of the esophagus.

Rumination is the repeated involuntary regurgitation of recently eaten food, which is either spat out or swallowed again. This cycle can continue several times within an hour after eating and usually stops when a sour taste appears in the mouth. Children do this with visible pleasure, making movements with the lower jaw and tongue that resemble chewing, ending this act with a swallowing movement. They often perform such regurgitation voluntarily, thrusting their fingers deep into the mouth. A similar phenomenon occurs in mentally retarded children, children with a neuropathic constitution (examination by a pediatric neurologist at the Markushka clinic).

Vomiting coffee grounds in oncology

Vomiting coffee grounds or mixed with unchanged blood is a common complication of stomach and esophageal cancer. The likelihood that the symptom is caused by cancer is especially high if the patient is over 55 years old. Often the patient loses a lot of weight.

In 2000, the journal JPSM (Journal of Pain and Symptom Management) published the results of a study in which researchers observed 800 patients with advanced cancer and assessed how often they experienced gastrointestinal bleeding. During the lifelong follow-up period, 18 patients developed overt symptoms of gastrointestinal bleeding: 12 had vomiting coffee grounds, 3 had melena (black, tarry stool), and 3 had both symptoms. The overall complication rate was 2.25%, while in the general population it was 0.1% (1 hospitalization for gastrointestinal bleeding per 1000 population).

According to some data, stomach cancer is complicated by bleeding in 4.6–23.4% of cases. Most often this occurs with stage III–IV tumors, usually located in the body or in the antral (lower, near the junction with the duodenum) part of the stomach. Main reasons:

• tumor disintegration;
• tumor ulceration;
• rupture of a blood vessel affected by a tumor;
• tumor destruction, purulent process, destruction and thrombosis of blood vessels, followed by necrosis and disintegration of tumor tissue.

The risk of gastrointestinal bleeding is quite high in patients with primary and metastatic liver cancer. In this case, portal hypertension occurs, varicose veins of the esophagus, and blood clotting decreases. Sometimes vomiting coffee grounds occurs as a complication of pancreatic cancer.

The risk of gastrointestinal bleeding in a cancer patient increases if pain is controlled with the use of nonsteroidal anti-inflammatory drugs.

What does vomiting coffee-like substance mean?

“Coffee ground” vomit is vomit that looks like coffee grounds. This occurs due to the presence of coagulated blood in the vomit. Vomiting blood is also known as hematemesis.

The color of vomit blood varies depending on how long the blood has been in the gastrointestinal (GI) system. If you have delayed vomiting, the blood will be dark red, brown, or black. The presence of coagulated blood in the vomit will make it look like coffee grounds.

This is a serious condition that requires immediate medical attention. Be sure to write down the time and amount you vomited and anything that may have caused you to vomit. If possible, take a sample of vomit and show it to your doctor for further testing.

What other symptoms may occur with bleeding in the gastrointestinal tract?

Vomiting coffee grounds may be accompanied by symptoms such as melena (black, tarry stool), abdominal pain, pallor, weakness, and dizziness. With serious blood loss, such menacing manifestations appear as chest pain, severe dizziness, loss of consciousness, cold sticky sweat, shallow rapid breathing, and a decrease in the amount of urine. If help is not provided in time, a state of shock develops and the patient may die.

If the bleeding is minor, there may be no symptoms. It is especially difficult to recognize this complication if the patient has anemia or cancer cachexia (exhaustion). As a rule, in such cases, a stool test for occult blood helps to establish the diagnosis.

Treatment

Prevention of diseases that cause involuntary eruption of brown liquid from the stomach is almost impossible. Analyzes and examinations do not predict the time zone of the risk of such a process.

How can they help in the hospital?

The doctor diagnoses the factors causing bleeding by studying the medical history. A person should talk about chronic diseases, how he eats, the presence of bad habits, hereditary pathologies and other information.

The body needs to stop bleeding and replenish lost blood volume. Droppers with solutions of medications will help normalize blood pressure and support the body. The patient is brought out of shock and digestive functions are brought back to normal.

The first day the patient is supposed to fast. The strictest diet is based on eating foods that are easy for the body. Liquid foods, low-fat dairy products, egg whites, all kinds of jellies are indicated during the recovery period.

What to do if you vomit coffee grounds?

If this happens at home, you should immediately call an ambulance. The patient’s life may depend on how quickly treatment begins.

First aid measures until the doctor arrives:

• Lay the patient down.
• Raise his legs up - this will increase blood flow to the brain.
• Place cold on your stomach.
• Do not administer any medications to the patient yourself - this may blur the clinical picture and worsen the condition.

You need to save some of the vomit to show it to the doctor.

Let's sum it up

Thick coffee vomit is considered an indication for medical attention because it may indicate a serious underlying condition. If left untreated, severe cases can lead to shock or even death. You should see a doctor as soon as possible for evaluation if you experience ground coffee vomiting.

Most cases of ground coffee vomiting can be treated. Most often, people can return home after diagnostic testing and treatment on the same day.

Sources:

Impulse follows strict sourcing guidelines and relies on peer-reviewed studies, research institutions and medical associations. We avoid using insufficiently expert links.

• Ansari P. (2016). Overview of GI bleeding. merckmanuals.com/professional/gastrointestinal_disorders/gi_bleeding/overview_of_gi_bleeding.html
• Bou-Abdallah JZ, et al. (2012). Coffee grounds emesis: Not just an upper GI bleed. DOI: 10.1016/j.jemermed.2009.05.008
• Diagnosis of GI bleeding. (2016). niddk.nih.gov/health-information/digestive-diseases/gastrointestinal-bleeding/diagnosis#procedures
• GI bleeding. (n.d.). my.clevelandclinic.org/health/diseases/17028-gi-bleeding
• Mayo Clinic Staff. (2018) Gastrointestinal bleeding. mayoclinic.org/diseases-conditions/gastrointestinal-bleeding/diagnosis-treatment/drc-20372732
• Mayo Clinic Staff. (2018). Vomiting blood. mayoclinic.org/symptoms/vomiting-blood/basics/definition/sym-20050732
• Treatment for GI bleeding. (2016). niddk.nih.gov/health-information/digestive-diseases/gastrointestinal-bleeding/treatment
• Vomiting blood (haematemesis). (2016). nhs.uk/conditions/vomiting-blood/

Diagnostic methods

It is important for the doctor to understand the causes and source of bleeding, and choose the right treatment tactics. Often you have to act very quickly. First of all, you need to find out what diseases the patient suffers from and whether he has taken any medications recently. Then an examination is carried out, which may include:

• Chest X-ray.
• General and biochemical blood tests (to diagnose anemia and assess liver parameters).
• Stool test for occult blood.
• Plain radiography of the abdominal cavity.
• Contrast-enhanced radiography.
• Endoscopic examination - FGDS.

Diagnosis of black vomit

To diagnose the stomach, you need to perform a gastroscopy

A qualified gastroenterologist must carry out treatment and make a diagnosis. In order to correctly determine the causes of the pathology, the patient will often be required to submit vomiting for tests. Characterizing it for the following parameters:

• smell;
• color of vomit;
• number of bowel movements;
• consistency of vomit.

FGDS (gastroscopy) of the stomach in case of black vomiting after alcohol is simply a mandatory procedure. The process of gastroscopy does not promise anything pleasant for the patient, but it will help to definitely find out the cause of bleeding in the stomach.

Additional procedures for an accurate diagnosis may include:

• ECG;
• a picture of the stomach taken on an X-ray machine;
• Ultrasound of the abdominal cavity;
• laboratory blood test.

Thanks to all of the above procedures, a specialist will be able to accurately determine the severity of the disease and the stage of its development. This will help make a diagnosis and prescribe a further course of treatment for the patient’s speedy recovery.