Throwing Up Blood After Drinking: Causes and Remedies

Why Am I Throwing Up Blood After Drinking?

Last night started as a happy hour with your colleagues, then devolved into a whirlwind of shots and two-for-one G&Ts. You caught a few hours of fitful sleep before suddenly waking. The sun isn’t up yet, and you feel awful. Your gut churns — you know what’s next. You catapult out of bed and crash through the bathroom door, barely making it to the toilet before emptying the contents of your stomach.

You catch your breath and reach up to flush, but something stops you. Is that … blood?

Hematemesis Explained

Typically, throwing up after drinking happens because of an influx of acetaldehyde. The liver creates this compound as it breaks down ethanol. When we drink too much alcohol, our body can’t turn the excess acetaldehyde into acetic acid, and anything left over is purged (that’s a delicate way of saying you’ll see those tequila shots again).

The act of vomiting consists of two phases: retching, or dry heaving, and expulsion. After a night out, our throw-up usually consists of any food and drinks we’ve recently consumed, along with a bit of stomach acid. If we spot bright red streaks of blood or a substance resembling coffee grounds, however, we may have cause for concern.

Any amount of blood in our vomit is referred to as hematemesis.

The term comes from the English prefix for blood (hemat-) and the Greek word for vomit (emesis). It’s distinct from melena and hematochezia — two terms referring to blood in our stool. However, we should note that all three can be signs of gastrointestinal bleeding. The color of the blood can provide clues about its origin. We’ll get into that later.

Bleeding in the GI tract is considered a medical emergency, whether we’re vomiting bright red, dark brown, or black. If left untreated, serious complications like anemia and hypovolemic shock can develop. Additionally, blood in our vomit can indicate damage to the liver, stomach, or esophagus. Speaking with a medical professional can reveal the issues behind the bleeding. In a lot of cases, the culprit is alcohol use disorder (AUD).

Blood in Vomit After Drinking Alcohol: Causes

Throwing up blood after drinking might signify anything from acute injuries to serious internal damage. In the best-case scenario, hematemesis can be attributed to nosebleeds that occur farther back in the nasal cavity. Unfortunately, most of the time, the explanation is related to a long-term pattern of heavy alcohol use and organ damage. There are seven potential causes of blood in vomit after drinking alcohol.

1. Nosebleeds.

Alcohol dehydrates our nasal passages, dilates our blood vessels, and increases our risk of conditions that lead to bloody noses. Researchers have found that habitual alcohol consumption increases the risk of nosebleeds. If that blood runs down our throat instead of out our nostrils, we may see it in our vomit.

2. Esophageal tears.

Regular, forceful vomiting irritates the delicate mucosal tissue protecting our esophagus — the tube connecting our mouth and stomach. If we continue drinking until we throw up, that continual irritation weakens the tissue, leading to gashes called Mallory-Weiss tears. The blood from these lacerations collects in the stomach and may be expelled through our sick or stool.

3. Varices.

Heavy alcohol intake can also lead to varices — enlarged esophageal veins that form in folks with liver damage. Varices may gradually leak or suddenly burst when irritated. If we barf bright red, esophageal damage might be to blame.

4. Gastritis and ulcers.

Gastritis is the technical term for the inflammation of our stomach lining. It causes nausea, abdominal pain, and vomiting. Severe cases of gastritis wear away protective tissue, creating open wounds called peptic ulcers. As these sores drain into the stomach, we may vomit blood.

5. Acute internal injury.

When we drink, we’re much more likely to sustain preventable injuries. Blunt-force abdominal trauma from car crashes, falls, or fights can lead to internal bleeding, stomach pain, and vomiting.

6. Cancer.

Heavy drinking increases the risk of certain cancers, including those of the colon, pancreas, small intestine, and liver. Tumors form within these structures, and, in the process, they create networks of abnormal, easy-to-rupture blood vessels. They also exert pressure on existing blood vessels, wearing away their walls. In these ways, cancer can cause internal bleeding.

7. Alcohol-related liver disease.

Alcohol-related liver disease (ARLD) is one of the most serious causes of blood in our vomit. The longer we drink heavily, the more likely we are to sustain irreversible liver damage in the form of cirrhosis — heavy scarring. As scar tissue builds up, our liver stops functioning as well as it should. Complications of ARLD include increased pressure in major veins, heightened risk of cancer, and the formation of varices. All these factors contribute to throwing up blood after drinking.

Types of Blood in Vomit

Are you seeing red or black vomit after drinking? The answer could reveal the root cause of this troubling symptom. What we expel gives our medical team insight into the state of our gastrointestinal system. Specifically, color provides clues about how old the blood is, where it comes from, and how we can treat it.

Red Blood in Vomit

Ruby-red blood is fresh and probably originates in the upper GI tract — usually the esophagus. Varices, irritation, and esophageal tears are all associated with red streaks mixed in with last night’s food and drink. Darker red blood containing clots might indicate heavy bleeding further down in the stomach, perhaps from a perforated ulcer.

Coffee Grounds Vomit

Throwing up black after drinking means there’s dried or coagulated blood in our GI tract. When internal bleeding occurs in the digestive system, the blood may be partially processed by the stomach, changing it into a dark substance with the texture of used coffee grounds. The comparison is so apt that doctors call this gastric-acid-addled substance “coffee ground vomitus.” It’s associated with ulcers, gastritis, cancer, and severe organ damage.

It’s important to note that intestinal damage is more likely to cause blood in our stool than in our vomit. That’s because the material in the bowels is too far down to be regurgitated. Instead, it progresses to the end of the digestive tract, where it is expelled as blood-streaked or tarry stool.

Is Throwing Up Blood Serious?

Yes. Hematemesis warrants emergency medical attention. First, it can be a sign of life-threatening conditions like gastrointestinal bleeding or alcohol-related liver disease. It might also signify acute issues such as esophageal tears, gastritis, or a major internal injury. Regardless of whether the blood is red or black, vomiting blood is a medical emergency. Visit the ER or call 911 if this symptom develops.

What Do You Do If You Throw Up Blood After Drinking?

Now that we understand the severity of hematemesis, we need to learn how to respond. Below are five essential steps to take when throwing up blood after drinking — everything from staying calm under pressure to swiftly seeking medical care.

1. Take a deep breath.


We know it’s hard, but don’t panic! While seeing blood in vomit after drinking alcohol may be frightening, getting overexcited can cloud our decision making and prevent us from clearly communicating with our healthcare team.  

2. Pay attention to symptoms.


Monitor what’s going on in your body. Do you feel dizzy or lightheaded? Is there any pain in your abdomen? If your vision blurs, your breathing accelerates, or you feel faint, call 911.

3. Don’t eat or drink anything.


Vomiting makes many of us reach for saltines, water, and stomach-soothing ginger. The situation is very different when we vomit blood. Resist the urge to add anything new to your stomach, especially more alcohol, which can aggravate the GI tract and worsen the bleeding.

4. Collect data. 


Whenever possible, document the color and consistency of your regurgitation. A quick photo may be helpful. Also make a note of how often you see blood in your vomit, how much alcohol you drank beforehand, and how regularly you consume alcohol. Share this information with your healthcare provider.

5. Go to the doctor. 


What do you do if you throw up blood after drinking? In almost all cases, vomiting blood warrants emergency medical attention. Call 911 to arrange transportation if you feel faint or don’t have anyone to take you to the ER.

Throwing Up After Drinking: When To Seek Medical Attention

Let’s be honest, throwing up after drinking is never a pleasant experience. But when does it become an emergency? While occasional bouts of post-party sickness may not be alarming, certain symptoms can signify that something is seriously wrong.

Emergency Symptoms

• Vomiting for more than 24 hours
• Signs of dehydration, including dry mouth, dark urine, and excessive thirst
• Inability to keep down food or liquids
• Neurological symptoms like dizziness, confusion, or a severe headache
• Blurred vision
• Severe abdominal pain
• Hematemesis: throwing up any amount of blood

If you ever feel unsure about whether your vomiting is normal, err on the side of caution and reach out to a healthcare professional. This is the only way to secure an accurate diagnosis and begin treatment.

What To Expect When Visiting a Doctor for Hematemesis

So, what happens when we make it to the hospital? First, the nursing staff will stabilize us, if needed. This usually involves the administration of IV fluids, antacids, and certain medications. Those of us experiencing more severe GI bleeds might require blood transfusions.

Once we’re feeling better, the doctors will take down information about our medical history. They’ll probably ask questions about our drinking habits and any past gastrointestinal issues. We’ll provide them with as much information as possible about the blood, how long we’ve seen it in our vomit, and any other symptoms we may be experiencing.

Next, the doctor will conduct a comprehensive physical exam. They’ll take our vitals and palpate our abdomen to look for any pain or swelling. After they’ve given us a once-over, they’ll run some tests. Diagnostic procedures for hematemesis usually include blood tests, ultrasounds, CT scans, or endoscopies. Blood tests allow our medical team to rule out disorders like anemia or hemophilia, while the other methods provide visualizations of our digestive tract. Ultrasounds and CT scans help doctors identify abnormalities; endoscopies offer a clear view of ulcers, irritation, and varices.

After the doctor has diagnosed the cause of our bloody vomit, they will create a treatment plan tailored to our needs. We should follow all their advice to the best of our abilities. While some people may need surgical intervention, many cases of hematemesis can be resolved through endoscopic therapies and lifestyle changes. With time, we may see our symptoms resolve.

Stop Vomiting Blood After Drinking

Throwing up blood can be a traumatic experience — one we’ll probably never want to repeat. Once we get a diagnosis, we should also change our lifestyle to promote gastrointestinal wellness.

Don’t drink. The first (and most important) way we can address alcohol-related hematemesis is to avoid drinking altogether. Alcohol is a leading cause of GI bleeding. If we struggle to quit, apps like Reframe offer creative, compelling solutions.

Eat well. Whole foods like lean proteins and fresh vegetables give our body the fuel it needs to recover after ulcers, varices, and related conditions. Steer clear of spicy, deep-fried, or fatty foods, which can irritate the stomach.

Say no to NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) are over-the-counter medications like ibuprofen (Advil), naproxen (Aleve), and aspirin (Bayer Aspirin). While these meds are widely available, we should avoid taking them too often. They irritate the stomach lining and increase the likelihood of GI bleeds.

Move more. Movement helps our gastrointestinal system function. While regular exercise is ideal, we can also reap the benefits of physical activity without strenuous workouts — consider taking a brisk walk after a meal to promote digestion, lower blood pressure, and regulate blood sugar levels.

Address chronic stress. Believe it or not, stress can worsen digestive issues. It ups our risk of irritable bowel syndrome (IBS), peptic ulcers, and a whole host of GI problems. Stress-reducing practices like yoga and meditation can provide relief and stave off other hematemesis-causing issues.

Take Control of Your Alcohol Use

This article has provided some guidance about what to do if we see red streaks or dark “coffee grounds” in our vomit. For many of us, throwing up blood after drinking alcohol is a wake-up call that our drinking has spiraled out of control. When we find ourselves in this situation, we should always seek medical attention. If our doctor recommends we cut back on alcohol (or cut it out entirely), we can consider using Reframe to make a lasting change.

For millions of users, Reframe is the key to drinking less and living more. With a combination of social support and research-based reinforcement, this proven program has helped Reframers change their relationship with alcohol. Download Reframe from the App Store or Google Play today.