Which symptom related to vomit color or consistency requires immediate attention during reflux monitoring?

Vomiting that is green or looks like coffee grounds.

Monitoring warning signs is crucial to ensure that reflux does not escalate into a dangerous situation requiring urgent specialist intervention. While forceful vomiting or difficulty swallowing are concerning, specific visual characteristics of the vomit signal an immediate medical necessity. Vomit that appears green suggests the presence of bile, indicating obstruction or severe irritation past the stomach. More critically, vomit that resembles coffee grounds signals the presence of partially digested blood, a sign of significant gastrointestinal bleeding. Therefore, the appearance of green vomit or coffee ground-like vomit warrants immediate consultation with a healthcare provider, as these signs point toward complications beyond typical GERD management.