Haematemesis

• The symptoms of haematemesis can range from a single small vomit to catastrophic life threatening bleeds.
• There are multiple causes of haematemesis in people with advanced disease:
• Coagulopathy
• NSAID and corticosteroid use
• Portal hypertension causing varices
• Tumour bleeding
• Stress ulcers.

Signs should be sought to confirm the diagnosis from the history.

• Consider and manage the underlying cause (for example tumour, NSAID, coagulopathy)
• Consider admission where there is a potentially reversible cause
• Stop anticoagulants, corticosteroids and NSAIDs where possible
• Commence a proton pump inhibitor
• Antifibrinolytics can be helpful but can be associated with increased thromboembolic disease
• Consider giving vitamin K.