Coffee Ground Emesis (Vomitus)

How do healthcare providers treat coffee ground emesis?

Your healthcare provider will work to isolate the cause and stop the bleeding if necessary. Often, the bleeding stops on its own, but they will still need to treat the underlying cause.

Initial examination

Your healthcare provider will begin by asking you about your medical history, including medications. They may ask if you have any other symptoms, such as:

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• Upper abdominal pain.
• Abdominal distension.
• Chronic acid reflux.
• Black, tarry poop.
• Frequent vomiting or coughing.
• Loss of appetite or involuntary weight loss.

Stabilization

Coffee ground vomit doesn’t usually indicate severe active bleeding. But if your provider suspects severe blood loss, they might want to test your blood volume. They do this by taking a blood sample through an IV. If your blood volume is low, they will work to replace it with IV fluids or blood transfusion.

Medical tests

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To confirm upper GI bleeding and investigate possible causes, your healthcare provider may give you various medical tests, including:

• Basic metabolic panel.
• Gastric or fecal occult blood tests (to look for blood in your emesis or poop).
• Liver function and kidney function tests.
• Electrocardiogram (EKG test).
• Upper GI X-ray series.
• Upper endoscopy (EGD test).

Treatment

Your provider may be able to address the bleeding during an upper endoscopy exam. This exam involves passing a tiny camera on a tube down your throat and into your upper GI tract while you are sedated. If the camera reveals the source of the bleeding, your provider can treat it by passing tiny medical tools through the tube such as clips or cauterization tools.

If they can’t find the source of the bleeding or stop it through these methods, sometimes providers will order special bleeding scans to try and locate the source of the bleeding along the length of your intestines. If the source of bleeding is identified, it can be treated in a minimally invasive manner such as embolization. This procedure is done by an interventional radiologist, a physician specially trained in this sort of procedure.

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Embolization involves accessing the bleeding vessel by inserting a catheter in your neck veins or groin veins. Once the culprit blood vessel is identified, your physician can block off the blood vessel by injecting special material to clog up the vessel.

If this is unsuccessful, the option of last resort is usually exploratory surgery. Providers can usually do this by minimally invasive methods. A laparoscopy uses the aid of a small camera and small surgical tools through small abdominal incisions (usually 1/2 inch or less).

Once your provider has identified and treated the source of the bleeding, they will address your underlying condition. You may have a chronic disease that needs comprehensive treatment. You may need to make lifestyle changes, or you may only need medication to treat an acute condition.

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