From the Guidelines
Coffee ground emesis is a medical condition characterized by vomiting of material that resembles coffee grounds, which is actually altered black blood [ 1 ]. This condition is often a sign of upper gastrointestinal bleeding, which can be caused by various factors such as ulcers, gastritis, or esophageal varices [ 1 ]. It is essential to seek immediate medical attention if coffee ground emesis occurs, as it can be a life-threatening condition.
Causes and Treatment
The causes of coffee ground emesis can be diverse, including:
- Ulcer disease
- Dieulafoy lesion
- Gastritis
- Esophageal varices Treatment typically involves:
- Stabilizing the patient
- Administering medications such as proton pump inhibitors like omeprazole 20-40 mg orally or intravenously every 12 hours
- Possibly undergoing endoscopy to identify and treat the underlying cause of the bleeding [ 1 ] In severe cases, blood transfusions or surgery may be necessary.
Importance of Medical Attention
It is crucial to note that up to 25% of patients with diabetic ketoacidosis (DKA) may present with emesis that can be coffee-ground in appearance and guaiac positive, related to hemorrhagic gastritis [ 1 ]. Therefore, seeking immediate medical attention is vital to prevent further complications and ensure proper treatment.
From the Research
Definition of Coffee Ground Emesis
- Coffee ground emesis, also known as coffee ground vomiting, is a condition where a person vomits a substance that resembles coffee grounds 2, 3, 4.
- This condition is often associated with upper gastrointestinal bleeding, but it can also be caused by other factors such as esophagitis, gastritis, or other non-GI bleeding-related conditions 4, 5.
Clinical Presentation
- The clinical presentation of coffee ground emesis can vary, but common symptoms include vomiting of coffee ground-like material, hematemesis, and melena (black, tarry stools) 2, 3.
- Patients with coffee ground emesis may also experience other symptoms such as abdominal pain, fever, and signs of systemic infection 5.
Diagnosis and Treatment
- Diagnosis of coffee ground emesis is often made through endoscopy, which can help identify the underlying cause of the condition 2, 3, 6.
- Treatment of coffee ground emesis depends on the underlying cause, but may include medications to control bleeding, endoscopic therapy, or surgery in severe cases 3, 6.
- In some cases, coffee ground emesis may not be related to upper GI bleeding, and patients may require evaluation for other non-GI bleeding-related conditions 4.
Prognosis and Outcomes
- The prognosis and outcomes of coffee ground emesis vary depending on the underlying cause and severity of the condition 2, 3, 6.
- In general, patients with coffee ground emesis due to upper GI bleeding have a higher risk of complications and mortality, while those with non-GI bleeding-related conditions may have a better prognosis 4, 5.