The Amount of Upper Gastrointestinal Bleeding That Causes Vomiting Blood

When the volume of upper gastrointestinal bleeding reaches approximately 200 to 300 milliliters, hematemesis—or vomiting of blood—can occur. This condition is commonly associated with disorders such as ruptured esophageal varices, gastric ulcers, stomach perforation, and gastric cancer. These diseases can damage blood vessels in the stomach wall, leading to internal bleeding.

Understanding the Threshold for Hematemesis

Smaller volumes of upper gastrointestinal bleeding typically pass through the digestive tract along with food, entering the lower digestive system without causing vomiting of blood. However, once the blood loss exceeds about 250 ml, the volume becomes too great to pass quickly through the pylorus, resulting in hematemesis. In such cases, melena—or black, tarry stools—often accompanies the vomiting of blood.

Severe Bleeding and Its Consequences

In more extreme cases, upper gastrointestinal bleeding can reach volumes as high as 1000 ml or more. This level of blood loss can lead not only to significant hematemesis but also to hypovolemic shock, a life-threatening condition caused by severe blood loss. Prompt medical intervention is crucial in these situations to stabilize the patient and prevent fatal outcomes.