What should you know about blood vomiting and black stool?

Black, sticky, tar-like stool can form when blood is digested as it passes through the upper digestive tract. Blood in vomit may be bright red or look like coffee grounds. Together, these signs can come from a stomach or food-pipe ulcer, irritation, a tear after retching, or enlarged veins associated with liver disease. Infection, migraine, or gastroenteritis can cause vomiting, but they do not explain away blood and black stool. The visible amount cannot show how much bleeding is happening inside.

Call emergency services or go to an emergency department now. Do not drive yourself, especially if you feel weak or have taken alcohol or sedating medicine. Sit or lie safely while waiting, and turn onto your side if drowsy or vomiting. Keep your medicine list and tell the team about ulcers, liver disease, alcohol use, and medicines such as blood thinners. Avoid aspirin and ibuprofen unless a clinician has specifically advised them.

Treat fainting, dizziness, confusion, pale or clammy skin, rapid breathing, a racing heartbeat, severe abdominal pain, or continuing vomiting as emergencies. Very little urine can signal poor circulation or dehydration. Even if the vomit is no longer bloody, black stool after a bleeding episode needs prompt evaluation because the bowel may still be passing digested blood.

Ask what may be causing the bleed, which tests are needed, and whether any current medicine should be changed. Ask what symptoms should trigger a return to emergency care and when follow-up should occur.