Black poop and abdominal pain: what to know

Dark foods, iron or bismuth can change stool colour without causing bleeding. In contrast, bleeding higher in the digestive tract may produce black, sticky, tar-like stool. Pain location and timing add clues: upper abdominal burning may occur with [Gastritis](/conditions/gastritis/) or [Acid Reflux](/conditions/acid-reflux/), while cramping and diarrhoea can accompany [Food Poisoning](/conditions/food-poisoning/) or gastroenteritis. These possibilities overlap, so appearance alone cannot identify the cause.

Note the stool texture, number of episodes, pain location, vomiting, fever and medicines taken. Avoid alcohol and anti-inflammatory painkillers until bleeding has been considered. Take small sips of fluid if you can keep them down, and do not eat foods that clearly worsen pain. Contact a clinician promptly for persistent black stool or pain; they may assess hydration, blood loss and abdominal tenderness.

Call emergency services for fainting, confusion, severe weakness, vomiting blood, a rigid or swollen abdomen, sudden severe pain, or black stools with breathlessness. Seek same-day care for repeated tarry stools, worsening pain, fever, persistent vomiting or inability to drink. Do not wait for the colour to return to normal if you feel increasingly unwell.

Could this be medication-related colour change or digestive bleeding? Does the pain pattern suggest gastritis, gallstones or another cause? Do I need examination, blood tests or stool testing, and which symptoms mean I should return urgently?