What reason is vomiting blood often when vomiting blood?

You must first distinguish between hemoptysis and hematemesis:

Hemoptysis, blood is coughed up, throat itches, and blood is weakly alkaline. Foamy, bright red in color, often mixed with phlegm. Hemoptysis often coughs up bloody sputum within a few days. Patients usually have a history of lung disease or heart disease.

Hematemesis, blood from the vomiting area, accompanied by nausea. Blood is mostly acidic, dark red or coffee grounds, which can be mixed with food and easily coagulated into blocks. Black stool is often discharged within a few days after hematemesis, and patients often have a history of stomach disease or liver disease.

Hemoptysis refers to the bleeding in the throat and any part of the respiratory tract below the throat, which is discharged through the mouth. Bleeding from mouth, nose and upper digestive tract is sometimes easily confused with hemoptysis. Nosebleeds often flow from the anterior nostril, and the bleeding focus is often located in the anterior and lower part of the nasal septum, which is easy to diagnose. Sometimes there is a lot of bleeding in the back of the nose, which is easy to be misdiagnosed as hemoptysis: blood flows down the pharyngeal wall from the back nostril, which can be diagnosed by nasopharyngeal endoscope. In addition, it is necessary to check the possibility of nasopharyngeal carcinoma, laryngeal cancer, oral ulcer, pharyngitis and gingival bleeding.

There are many reasons for hemoptysis, mainly respiratory and circulatory diseases.

I. Respiratory diseases

(1) Bronchial diseases: bronchiectasis, bronchogenic carcinoma, endobronchial tuberculosis, chronic bronchitis, bronchial foreign bodies, etc.

(2) Lung diseases: tuberculosis, pneumonia, lung abscess, lung infarction, paragonimiasis and lung metastasis of malignant tumor.

Second, circulatory system diseases

Mitral valve stenosis, ventricular septal defect, pulmonary arteriovenous fistula rupture, etc.

Third, others.

Blood diseases (such as hemophilia, leukemia, aplastic anemia, thrombocytopenic purpura, etc.). ), acute infectious diseases (such as oral epidemic hemorrhagic fever, pulmonary hemorrhagic leptospirosis, etc. ), rheumatism (such as nodular periarteritis, Behcet's disease), tracheobronchial endometriosis, etc.

Cough volume is small within 100ml per day, moderate within 100 ml-500ml, and large above 500ml (or 300 ml-500 ml at a time). Massive hemoptysis is mainly seen in pulmonary tuberculosis cavity, bronchiectasis and chronic lung abscess; The main manifestation of hemoptysis in bronchial lung cancer is continuous or intermittent bloody sputum, and massive hemoptysis is rare. When the cough of chronic bronchitis is severe, there may be bloody sputum occasionally.

spit blood

[Symptom characteristics]

Hematemesis refers to the blood that stays in the esophagus or stomach and spits out from the mouth when the upper digestive tract bleeds, mostly brown or bright red or dark red.

【 Etiology and key points of differentiation 】

(-) Gastric and duodenal ulcers

Bleeding due to blood vessel rupture caused by ulcer. The color of hematemesis is dark red. The patient has a history of ulcer with black stool.

(2) Chronic gastritis

Less bleeding, epigastric pain, indigestion and other symptoms after eating.

(3) Cirrhosis

Esophageal and gastric varices rupture and bleed, with a large amount of hematemesis and bright red color.

(4) Cancer

1. Esophageal cancer: mostly a small amount of persistent bleeding, mostly elderly men, accompanied by dysphagia, reflux, hiccups, emaciation and other symptoms.

2. Gastric cancer: hematemesis is coffee residue-like, and the pain relief after hematemesis is not significant, and the onset age is mostly over 40 years old.

(5) uremia

I have a history of chronic kidney disease, and my breath smells of ammonia.

(6) Biliary diseases

There are gallbladder enlargement, biliary colic, jaundice, and colic is relieved after hematemesis. Keep it if it works.