Coffee ground emesis (or vomitus) is vomit that looks like coffee grounds. It’s dark brown or black in color with a lumpy texture. The appearance comes from old and coagulated blood in your gastrointestinal tract.

Overt bleeding might show up as: Vomiting blood, which might be red or might be dark brown and look like coffee grounds. Black, tarry stool. Rectal bleeding, usually in or with stool. With occult bleeding, you might have: Lightheadedness. Difficulty breathing. Fainting. Chest pain. Abdominal pain.

Coffee ground vomitus is dark-colored vomit that has blood in it. Possible causes include gastric ulcers, gastritis, liver disease, and cancer.

In the context of a known GI bleed, coffee ground emesis is highly specific for an upper GI bleed (vs. swallowed blood from posterior epistaxis). The presence of coffee ground emesis implies less active bleeding compared to hematemesis (blood had time to congeal in stomach).

Only 20% of patients with a positive fecal occult have an identified upper GI bleed. [3] For short-term prophylaxis against SBP and bacteremia [10] Indications: Consider initiating massive transfusion protocol. For life-threatening hemorrhage if endoscopy is not available.