Gastric bleeding is the entry of blood into the stomach cavity either due to inflammation, infection or rupture of the stomach lining. The gastric lining is highly vascularized (extensive blood supply) and any factor that may compromise the integrity of this lining can result in bleeding. This can vary from minute cuts and sores in the lining, bleeding ulcers to actual tears of the stomach wall. Stomach bleeding is also referred to as gastrorrhagia and a gastric hemorrhage.

Any sign of upper gastrointestinal bleeding should be taken seriously and immediate medical treatment should be sought. It is difficult to identify the exact location of a gastrointestinal bleed by the signs and symptoms alone and diagnostic investigations by a medical professional is necessary. Most cases of upper gastrointestinal bleeding (esophagus, stomach, duodenum) is a result of bleeding within the stomach. There are a host of causes of gastric (stomach) bleeding, some of which can be acute and may not require treatment, while others could be related to serious chronic conditions.

Stomach Bleeding Signs and Symptoms

Bleeding from the stomach can cause a host of signs and symptoms, some of which may clearly indicate a bleed while others can be vague and mistaken for other gastrointestinal conditions. Common signs and symptoms of stomach bleeding include :

  • Vomiting of red, ‘fresh’ blood (hematemesis).
  • Vomiting of ‘old’, brown to black blood which resembles coffee grounds.
  • Presence of ‘fresh’ blood in the stool (hematochezia).
  • Black tarry stool due to the presence of ‘old’ blood (melena).
  • Epigastric¬† pain (upper middle part of the abdomen, just below the breastbone) which may vary from sharp, stabbing pains to stomach cramps.
  • Dizziness/lightheaded feeling.

Not all these signs and symptoms of stomach bleeding may be present and the presence of blood in the vomit (hematemesis) is sufficient to make a differential diagnosis of upper gastrointestinal bleeding. Hematemesis may be due to bleeding elsewhere, including the mouth and upper respiratory tract, so it has to be differentiated from upper gastrointestinal bleeding with an upper GI endoscopy.

Other signs and symptoms of stomach bleeding includes :

  • Other gastrointestinal symptoms including indigestion and heartburn.
  • General abdominal pain.
  • Fatigue and shortness of breath in chronic bleeding.
  • Fainting if there is significant blood loss.
  • Lack of appetite.
  • Loss of weight in chronic cases.
  • Low blood pressure (hypotension). *
  • High heart rate (tachycardia). *
  • Signs of shock in cases of significant blood loss. *
  • Anemia.
  • Pallor. *
  • Sweating. *
  • Smell and taste of blood. This is subjective but is sometimes reported by patients with upper gastrointestinal bleeding.

* Red flag signs that are considered a medical emergency.


Article reviewed by Dr. Greg. Last updated on June 7, 2010