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Updated on July 31, 2023
7 min read

What Causes Brown Vomit on an Empty Stomach?

Alyssa Hill
Dr P. E. Pancoast, MD
Written by 
6 Sources Cited
Alyssa Hill
Written by 
6 Sources Cited

Vomiting is a common symptom associated with many medical conditions, and it can range in color from clear to green. Brown vomiting, however, is an alarming sign of distress for any person prone to vomiting—especially on an empty stomach.

This post explores possible causes of brown vomit when nothing else has been ingested for hours or days. It also discusses the need for seeking prompt medical attention when experiencing this symptom.

What Does The Color of Vomit Indicate?

Determining the color of vomit can provide insight into a person's well-being. It can also aid in diagnosing potential health issues.

While vomiting is a usual bodily response to outside invaders, chronic or persistent vomiting can indicate underlying gastric problems, making swift diagnosis imperative.

Consulting with a physician regarding the color of vomit can lead to a more informed assessment and targeted treatment protocols.

Understanding The Different Colors of Vomit

Here's what you need to know about a few of the most common colors of vomit and the potential underlying causes:

the different colors of vomit 1

Clear

Clear vomit is often a normal reaction when your stomach is empty or in cases of morning sickness. It's also not a medical emergency if you feel lighter after throwing up or if you have a stomach bug.1

However, contact a medical professional if these symptoms persist for more than a few days or if you're uncertain about the cause. Additionally, you should seek immediate medical attention if:

  • You can't eat or drink anything without feeling sick
  • You vomited clear liquid after a head injury since it may indicate a severe brain injury or trauma
  • Your clear vomiting doesn't resolve within 24 hours
  • Your vomitus (the substance you expel) is very forcefully projected (projectile vomiting) 

Yellow or Green

When the stomach is empty, or there is a blockage in the intestines, vomit can contain bile which may appear yellow or green. Bile is a yellow-green digestive fluid that helps break down fat, and it's excreted from the gallbladder.

Green or yellow vomit isn't often a cause for concern—empty stomachs commonly cause bile-related vomiting. ​​However, you should consult a doctor if the vomiting persists for more than 24 hours or if it’s coupled with:

  • Constipation
  • Severe chest pain
  • Progressively severe lower abdominal pain
  • Fever
  • Weakness
  • Other problematic symptoms

The other possible contributors to yellow vomit include:2

  • Gastroenteritis from food poisoning
  • Yellow or green drinks or foods
  • Mucus from a cold or flu
  • Pus from infection

Brown

Brown vomit can signal two potential causes:

  • Presence of blood
  • A severe case of constipation

Foods like chocolate and dark-colored items could trigger this condition but may also point to underlying health issues.2 

Brown, bloody vomit could also indicate hematemesis. This condition involves a noticeable amount of blood in the stomach contents. Bright red vomit signals fresh bleeding, while darker colors suggest older blood. 

Moreover, be cautious if your vomit appears like dark coffee grounds—especially if you're experiencing brown vomit that wasn't brought about by overindulging in chocolates or brownies. Having this could indicate potential stomach bleeding.

Brown Coffee Ground Vomit

Coffee-ground vomitus, which appears dark brown or black with a lumpy texture resembling coffee grounds, is a type of hematemesis indicating internal bleeding.4 This medical emergency occurs due to coagulated blood from dried, dark, and congealed bleeding.

The causes of this kind of hematemesis are the same as other types, but it's crucial to determine its root cause to prevent blood loss and shock. 

Red or Pink

Immediate medical attention is necessary if vomit appears red or pink, as it could indicate the presence of blood. A small amount isn't harmful unless you have suffered an injury, nosebleed, or swallowed some blood. 

If this happens occasionally and ceases when vomiting stops, there’s no cause for concern. Vomiting a small amount of blood once or twice and then clearing up quickly is also not a significant issue.

Red or pink vomit may also be related to various conditions, such as:

  • Esophagitis
  • Ulcers
  • Stomach tumors
  • Esophageal varices
  • Gastritis
  • Tears in the esophagus due to constant vomiting

Black

Black or very dark brown vomit resembling coffee grounds could be blood. Likewise, it could also result from the kale and spinach in your diet or dark-colored beverages and desserts consumed the previous night.

However, if your vomit is black, red, or coffee-ground colored without a clear culprit, seeking medical attention is essential. Internal bleeding further down the digestive tract can cause old blood to darken over time, particularly if you have a history of stomach upset, pain, or digestive issues. 

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What Causes Brown Vomit on an Empty Stomach?

Bile and stomach acids are common causes of brown vomit, particularly on an empty stomach. This is due to the lack of content in the gut that would ordinarily act as a buffer against it.

The release of these substances, which are yellow-green or yellow-brown, can also occur due to bile reflux. Bile reflux often happens when there's a backup of bile in the stomach and esophagus, resulting in a burning sensation in the chest accompanied by nausea and vomiting.

Other Potential Causes of Brown Vomit

Aside from the ones mentioned above, brown vomit can have different root causes:1,3

  • Heartburn
  • Amyloidosis
  • Peptic ulcers
  • Acid reflux
  • Ulcers
  • Fungal infections such as phaeohyphomycosis
  • Swallowed blood from a nosebleed
  • Cyclic vomiting disorder
  • A severe case of food poisoning that has led to internal bleeding

A bowel obstruction can cause brown vomiting, abdominal pain, and an unpleasant odor. It can impair digestion and result in bloating and severe abdominal pain. 

When is Brown Vomit A Cause for Concern?

You should seek immediate medical help if you vomit brown material that looks like coffee grounds. As mentioned, this could indicate severe gastric bleeding; a doctor should evaluate it immediately.

These other signs warrant urgent professional assistance since they may signify your body going into shock:4

  • Shallow breathing
  • Dizziness
  • Shortness of breath
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How Is The Cause of Brown Vomit Diagnosed?

Your doctor may conduct a physical exam and order blood tests to determine the source of your brown vomit. Testing the vomitus for the presence of occult blood is a typical starting point. They may also suggest undergoing upper gastrointestinal endoscopy. This procedure uses a flexible, lighted tube with an attached camera to examine the digestive tract.5

Imaging tests, such as a CT scan or MRI, may also be recommended to assess any blockages or abnormalities in the digestive tract. These exams will help them evaluate the cause of your condition and provide targeted treatment.

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How Can Brown Vomit Be Treated or Prevented?

Treating the source of your brown vomit is crucial to preventing future bouts. Based on the diagnosis, your doctor may recommend medications, lifestyle modifications, or dietary changes.

These can help reduce symptoms and provide relief from the causes of brown vomit. You can also do most of them at home, thus eliminating the need to take time off from work or school.

Medical Treatments for Brown Vomit

Treatment for brown vomit will depend on its underlying cause. Your doctor may advise taking medications such as:6

  • Antibiotics
  • Antacids
  • Proton pump inhibitors (PPIs)
  • Anticholinergic drugs
  • H2 blockers

In severe cases, they may also advise undergoing surgery to stop severe bleeding or correct structural abnormalities. Surgery is also recommended for patients with bile reflux.

Lifestyle Changes And Home Remedies

Making lifestyle changes may help prevent brown vomit. These include:

  • Drinking plenty of fluids
  • Eating a balanced diet
  • Avoiding alcohol and smoking
  • Managing stress levels 
  • Avoiding trigger foods, such as spicy or fatty dishes
  • Limiting caffeine intake
  • Exercising regularly
  • Getting enough sleep every night
  • Consulting your doctor for any digestive issues or pain
  • Medication and stress reduction techniques for people with cyclic vomiting disorder

Additionally, specific home remedies may alleviate nausea and vomiting caused by brown vomit. These include:

  • Drinking ginger tea
  • Staying hydrated and taking small sips of clear liquids
  • Drinking beverages with electrolytes
  • Sucking on a piece of ginger
  • Eating smaller and more frequent meals
  • Avoiding lying down for at least two hours after eating to reduce the chances of reflux

Conclusion

Various conditions, including bile reflux and internal bleeding, can cause brown vomit. It's essential to know the potential signs and causes and seek medical advice if you experience them.

Treatment will depend on the underlying cause; your doctor may suggest lifestyle changes or medications to manage it. By understanding what brown vomit means and how to respond to it, you can take the necessary steps to protect your health.

Updated on July 31, 2023
6 sources cited
Updated on July 31, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Khodadadian, S. “Vomit Color– Green, Yellow, Brown, Black, Clear.” Manhattan Gastroenterology, 2022.
  2. Bezerra, C. “Vomit Color Chart: Throwing-Up Yellow, Green, Black or Red.” Tua Saúde, 2023.
  3. Kenny, T. “Vomiting Blood.” Patient, 2012.
  4. Thacker, D. “Strange Color Vomit: When It’s a Sign of a Bigger Problem?” Healthnews, 2023.
  5. U.S. Department of Health and Human Services. “Diagnosis of Cyclic Vomiting Syndrome.” National Institute of Diabetes and Digestive and Kidney Diseases, 2017.
  6. Pinto-Sanchez, M. I. “Proton pump inhibitors for functional dyspepsia.” The Cochrane Database of Systematic Reviews, 2017.
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