What should you know about black pasty stool?

The bowel normally contains mucus and water, so consistency changes with hydration, fibre, constipation, and intestinal movement. Pasty black stool can also follow iron or bismuth. A more concerning pattern is black stool that is sticky, tarry, unusually strong-smelling, or repeatedly present. Digested blood from the stomach or upper intestine can look this way.

Gastritis, Peptic Ulcer, and Helicobacter Pylori Infection may be considered when there is indigestion, upper abdominal discomfort, nausea, or a history of stomach irritation. The symptom does not establish any one condition.

Check the labels of recent medicines and supplements, and record the timing of the colour change. Tell a clinician about anti-inflammatory painkillers, aspirin, alcohol use, previous ulcers, and any change in appetite or bowel pattern. Arrange prompt advice if the stool is unexplained or repeats. Avoid taking extra painkillers to manage abdominal discomfort until you know which options are suitable for you.

Seek emergency help if black pasty stool is accompanied by fainting, worsening weakness, severe dizziness, pale or clammy skin, confusion, breathlessness, severe pain, or blood or coffee-ground material in vomit. These features can occur with digestive blood loss. If you are stable but the stool remains black, seek same-day advice for an examination and possible testing.

Could iron or bismuth explain this consistency and colour? Is there evidence of bleeding or anaemia? Should I be assessed for Gastritis, Helicobacter Pylori Infection, or Peptic Ulcer? Which medicines should I avoid until the cause is clearer?