Throwing up blood after drinking alcohol has numerous causes, varying in severity. It can indicate a serious issue in some cases. Small streaks of blood may not be a cause for immediate alarm, but throwing up larger amounts of blood can be a medical emergency.

Regardless of what causes blood in the vomit, it is important to care for the body and monitor the symptoms closely.

Keep reading to learn more about the possible causes of throwing up blood after drinking alcohol.

Woman holding painful throat.Share on Pinterest
Alcohol and smoking can both dry out the throat, leading to irritation and streaks of blood in the vomit.

A person may throw up blood after drinking for different reasons, depending on factors such as how much they drink and their other lifestyle choices.


In some cases, streaks of blood showing up in the vomit may be a sign of simple irritation in the throat. Various factors could be responsible for this.

Alcohol itself may dry out the throat as a person drinks. Smoking cigarettes, which many people do alongside drinking, may also dry out the throat.

The throat can be more easily irritated when it is dry, and the act of vomiting is very irritating to the throat. Both dry heaving and vomiting can irritate the throat tissue. The contents of the vomit may irritate or burn the throat tissue as well. All in all, this may lead to a rough, sore throat that is more prone to bleeding.

Swallowing blood

Minor injuries, such as a nosebleed, may cause a person to swallow blood. During a bout of heavy drinking, a person might not be aware that they swallowed the blood or had a nosebleed until they vomit up the blood.

The blood may look different, depending on its age. Fresh blood will be red and may streak the vomit. Older blood may look more brown and have a texture similar to that of coffee grounds.

Peptic ulcer

A peptic ulcer is an open sore in the stomach, small intestine, or esophagus (food pipe). It can occur when the gastrointestinal (GI) tract loses part of its protective lining in one area. Peptic ulcers can be painful and cause bleeding.

A single bout of drinking may not cause a peptic ulcer, but regular drinking can be a risk factor for damage to the stomach that could cause ulcers.

A person with an ulcer may experience other symptoms alongside bleeding, such as:

  • heartburn
  • nausea
  • bloating
  • indigestion
  • stomach pain that gets worse with an empty stomach
  • burning pain in the abdomen

Peptic ulcers can perforate the GI lining and cause bleeding, which could be the reason for blood in the vomit after drinking.

Regular drinkers might be at higher risk regardless of the amount of alcohol they drink per session. A study in PLOS ONE found that drinking just one or two drinks per day increased the risk of peptic ulcers in men. Men who drank more than this had a further increased risk.

Gastritis and gastropathy

Gastritis is inflammation of the lining of the stomach. Gastropathy occurs when there is damage but no inflammation.

Although it is not the only possible cause, the National Institute of Diabetes and Digestive and Kidney Diseases note that drinking alcohol may easily cause gastropathy, as the alcohol may irritate or damage the stomach lining.

Bleeding may not be the only symptom that a person with gastritis or gastropathy experiences. Other possible symptoms include:

  • bloating
  • nausea
  • feeling full quicker than usual or feeling too full after an average-sized meal
  • burning stomach pain
  • a grumbling or deep pain
  • loss of appetite

A large quantity of blood in the vomit is a sign to seek medical attention.

Excessive drinking may also be a risk factor for chronic cases of these conditions.

Open gastrointestinal bleeding

Throwing up a lot of blood could be a sign of more serious GI bleeding somewhere along the digestive tract, which will require medical attention.

Other concerning symptoms of internal bleeding include:

  • confusion
  • fainting
  • dizziness
  • blurred vision
  • pale skin
  • shallow or rapid breathing
  • confusion or difficulty focusing

Vomiting a lot of fresh blood may be a sign of active bleeding, and the person should seek immediate medical attention.


Varices are swollen veins along the GI tract, typically in the intestinal tract or stomach. These swollen veins may appear after trauma or when something, such as scar tissue, blocks blood flow to the veins in the area.

Alcohol-related liver disease may be a risk factor, as a heavy drinker may be more prone to damage and scar tissue in the GI tract. This damage can cause varices, which may bleed.

A study in the Journal of Research in Medical Sciences notes that about 50% of people with cirrhosis have these varices and that their presence becomes more likely as the severity of the disease increases.

Damaged and bleeding varices may lead to symptoms such as:

  • coughing or vomiting large amounts of blood
  • vomit that resembles coffee grounds
  • black or bloody stool
  • fainting or confusion
  • weakness and lightheadedness

Anyone experiencing the symptoms of bleeding varices should seek medical attention.

Alcohol-related liver disease

Alcohol itself is a risk factor for damage in the liver and liver disease, especially with long-term use. Drinking alcohol regularly increases a person’s risk for liver disease, including cirrhosis, fatty liver, and alcoholic hepatitis.

A study in the American Journal of Gastroenterology notes that about 10–20% of regular heavy drinkers develop severe forms of alcohol-related liver disease.

While this shows that there are other risk factors, it is clear that regular heavy alcohol use can lead to alcohol-related liver disease. This disease can also result in complications that cause a number of symptoms, such as:

  • nausea
  • vomiting
  • blood in the vomit
  • anorexia
  • inflammation and damage in the liver
  • yellowing of the skin (jaundice)
  • severe thirst
  • tarry, bloody, or black stool

Alcohol-related liver disease may also be a risk factor for other issues, such as varices or ulcers.

The main risks associated with drinking and throwing up blood are damage to the liver and alcohol-related liver disease, which are prevalent among regular drinkers.

A 2018 study notes that alcohol-related liver disease is one of the main causes of chronic liver disease worldwide. Additionally, alcohol is a risk factor in people who have other forms of liver disease, such as that resulting from the hepatitis C virus.

It may not always be possible to avoid throwing up blood after drinking, but abstaining from alcohol will be an effective preventive measure for many people.

Drinking alcohol over time increases the risk of liver damage and its related issues, which may increase the risk of vomiting blood.

It may also help to remove other risk factors for bleeding, such as regular nonsteroidal anti-inflammatory drug (NSAID) use. Drinking water and staying hydrated may eliminate dehydration, which could prevent throwing up blood due to the irritation of a dry throat.

The cause of throwing up blood after drinking is sometimes obvious. The person may notice some old blood in their nose from a nosebleed, which may also have been responsible for the blood in the vomit.

However, even in cases with a simple cause, it is probably a good idea to see a doctor. A proper diagnosis can help identify any underlying conditions and other risk factors, as well as putting a person’s mind at ease.

Anyone experiencing serious symptoms, such as throwing up large amounts of blood, should seek immediate medical attention. Other concerning symptoms include:

  • dizziness
  • confusion
  • pain
  • rapid breathing
  • loss of consciousness

Throwing up blood after drinking has a few different causes, ranging from irritation in the area to a more serious underlying condition.

Anyone throwing up blood after drinking should contact their doctor, who can identify any underlying conditions or risk factors.

Concerning symptoms, such as throwing up a lot of blood, are signs to seek emergency medical attention. Regular alcohol drinkers may be more at risk for some types of damage that lead to blood in the vomit. Avoiding alcohol use may help reduce or eliminate the risk of some causes.