Need a virtual hand hold , husband vomiting blood

But how will they know if they’re not running any tests?

Hi OP I am sorry to hear about your husband. My daughter is currently very unwell with Faecal Impaction, she only got diagnosed yesterday after 4 weeks of severe pain etc etc
It only got found after me insisting on a stomach x-ray (previous ultrasound a few weeks ago was clear). She has vomitted because of it but not had any blood coming up.
I would insist on further tests including an x-ray to be done. It is absolutely disgusting having to fight for medical assistance for our loved ones.

I hope he is feeling better soon it is extremely worrying x

Something similar happened to my DH a while back. Fainting was caused by low blood pressure and low iron due to bleeding somewhere in his stomach. He was admitted and spent several days there. Had several blood transfusions and investigations including scans, endoscopy and colonoscopy. They never really found a cause and it hasn’t repeated itself since.
I can’t believe they just want to send him home! You need to get there and advocate for him.

I would have thought that that would be an emergency by now!

Are you with him yet?

@Justmeeeindie op dh will be too ill to feel assertive . You have to speak up for him .
Tell them he absolutely will NOT be leaving without scans and further investigation.
Use the word negligence
Do what you need to for your dh to have the medical care he needs .

IF he isn't actively bleeding then they may want things to settle down before doing an OGD

You had the same - a number of years ago - probably when beds weren't at a premium as they are now -

You may have needed a blood transfusion - the OP husband may not
You may have needed iron transfusion - the OP husband may not

Could it be volvulus? I guess they'd know if they do a scan. If so then it needs untwisting manually. I hope he's better soon x

So sorry to read this. I could hear the worry in your posts, and I can well believe how concerned you are.

What exactly is the point of A+E if they are not sorting out his constipation, or checking for a bowel blockage, do they expect patient and family to be medical experts and nurses now and do it themselves? I am not trying to make you any more worried than you already are, but internal bleeding like that can be very serious.

I had the same a number of years ago. A+E kept me in, did endoscopy two days later, discovered ruptured ulcer and H Pylori infection. Treatment started for that, then I had to have blood transfusions, and after discharge an iron infusion. It was NOT a good experience at all! But I'm ok again now.

I think I'd be just as concerned about the constipation for two weeks as I would about the coffee ground vomiting.

I hope you get some answers, and that he will be OK.

Coffee grinds aren't usually bile, they're indicative of blood .

He's not still constipated is he?

Ever such a worry, you must be frantic. We are so used to saying "he's in the best place" but it doesn't always feel so simple these days.

Do you have any friends who could drop in on your eldest for a bit? She's got quite a lot on her plate this evening - however skilled a big sister she is, multiple poorly kids, including a 2 year old, after a long day at college is a lot. I know people are busy but a couple of hours this time of night is not a big ask, especially in families with older children.

Coffee grounds is usually bile, I don't know if he can refuse to be discharged if his condition has not improved, but if he has the strength or if you're with him, be quietly insistent. Good that he's stopped vomiting but any internal bleeding is a concern. Don't let them fob you and your husband off again.
I'm so sorry you're both going through this.

My Dad had a perforated ulcer and was vomiting black blood everywhere, all over bed, floor and wardrobes, it was very scary. I can’t remember how long he was in hospital for, but I didn’t go and see him, so presume not long and not overnight, he was late 70’s. He never experienced this again and he never knew he had an ulcer. Hoping your DH gets his diagnosis soon and an action plan.

DH committed blood once every 15/20 minutes for around 2 hours - called an ambulance and admitted to hospital early Sat morning. Lots of test before discharge Monday with from memory anti reflux meds and an ultrasound appointment

The cause was never found and never repeated

Sounds like he needs to see a specialist but whether it’s an emergency or to be done via gp depends on whether he’s stable or not, if an ulcer they can prescribe treatment but he won’t necessarily be admitted unless active bleeding, they should refer back to gp if discharging so they can arrange an endoscopy. My dad was vomiting blood and it was only an ulcer which was easily treated, he was pretty woozy but he doesn’t deal with pain or blood well, his endoscopy wasn’t in a&e it was about 2 weeks later (I presume 2 week pathway basically)

Sending hugs. What do they think the blood/coffee grounds in the vomit was? You can get a minor oesophageal tear from vomiting which can make you vomit blood, but that’s usually a diagnosis of exclusion/seen on endoscopy.

Here is a guidline of treatments/Investigations. Do you have anyone who can advocate for him
⚠️ 1. Initial Assessment

• A → Airway, B → Breathing, C → Circulation
• Vital signs: Check for hypotension, tachycardia, fever
• Assess for complications:
• Bleeding: Hematemesis, melena, hematochezia, low Hb
• Perforation: Sudden severe pain, rigid abdomen, free air on X-ray
• Obstruction: Vomiting, distension, inability to tolerate oral intake

• Blood tests:
• Full blood count (Hb, WBC)
• Urea, electrolytes, creatinine
• Liver function tests
• Group and cross-match (if bleeding suspected)
• Amylase/lipase (if perforation or pancreatitis suspected)
• Stool test: For occult blood or H. pylori antigen (if stable)
• Imaging:
• Erect chest X-ray (for free air → perforation)
• Abdominal ultrasound or CT (if diagnosis uncertain)
• Endoscopy: Usually done after stabilization, for diagnosis and possible therapy (bleeding control, biopsy).

• IV access ×2, large bore
• Fluid resuscitation: Normal saline or Ringer’s lactate
• Blood transfusion if Hb <7 g/dL (or <9 if cardiac disease)
• IV proton pump inhibitor (PPI):
• Omeprazole 80 mg IV bolus, then 8 mg/hour infusion
• NPO (nil per os) – no oral intake
• NG tube if vomiting or upper GI bleeding
• Call gastroenterology or surgery urgently for possible endoscopy or intervention

• Oral or IV PPI: Omeprazole, pantoprazole, or esomeprazole
• Pain control: Avoid NSAIDs and opioids if possible
• Test for Helicobacter pylori
• If positive → Triple therapy:
• PPI (e.g. omeprazole 20 mg BID)
• Clarithromycin 500 mg BID
• Amoxicillin 1 g BID (or metronidazole if penicillin allergy)
• For 14 days
• Avoid irritants: NSAIDs, alcohol, smoking, spicy foods

• Admit if:
• Active bleeding
• Hemodynamic instability
• Perforation or obstruction
• Severe pain or vomiting
• Elderly or comorbid patients
• Discharge with outpatient follow-up if:
• Stable
• No red flags
• Can tolerate oral meds and fluids
• Given H. pylori test and PPI prescription

• Review in 2–4 weeks
• Repeat endoscopy if:
• Ulcer was gastric (to rule out malignancy)
• Symptoms persist
• Ensure eradication of H. pylori confirmed by breath or stool test (after 4 weeks off PPI)

Woudl an ulcer have him in and out of consciousness, and if so, how can they discharge him without a plan to avoid intermittent unconsciousness?

He needs a scan and endoscopy. Pretty normal to be discharged and come back for an endoscopy but I'd expect a scan to be done whilst he's in. If he's discharged, it's worth going to GP and see if they'll admit him through SDEC or SAU rather than a and e.

Surely they’d want to be confident they know what’s wrong and that it’s not going to happen again?

I’m surprised they aren’t at least doing some sort of scan or physical exam, not just bloods.