What are the key differential diagnoses to consider in a patient with haematemesis?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

When a patient presents with haematemesis, key differential diagnoses to consider primarily include conditions causing upper gastrointestinal bleeding .

  • Oesophageal or stomach cancer is a significant differential diagnosis for haematemesis . For this, a non-urgent, direct access upper gastrointestinal endoscopy should be considered .
  • Upper gastrointestinal bleed in general is indicated by haematemesis .
  • In some cases, particularly in infants, ingested blood from sources like a nosebleed or a cracked maternal nipple should be ruled out as a cause of blood-stained vomit .
  • Peptic ulcer disease is also a strong risk factor for subsequent upper gastrointestinal bleeding, which can manifest as haematemesis .

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.