Vomiting blood and black poop: what to know

Black, sticky, unusually smelly stools can form when blood has been digested as it travels through the gut. Alongside blood in vomit, this pattern can point to bleeding from the stomach or food pipe. Possible causes include ulcers, irritation, a tear after repeated vomiting, or enlarged veins. The appearance can be altered by iron or some foods, but blood in vomit makes this combination unsafe to monitor at home. A medical team may assess the stomach and oesophagus, including for conditions such as oesophageal cancer or stomach cancer when appropriate.

Seek emergency medical care now. Do not drive if dizzy, weak, or sleepy; ask someone to stay with you and bring a list of medicines. Avoid alcohol, aspirin, and ibuprofen unless prescribed for a specific reason. Do not try to treat the bleeding with food or home remedies. If possible, keep a sample or photograph of the vomit and describe whether the stool was tar-like, sticky, or mixed with red blood.

Call emergency services immediately for fainting, confusion, cold or clammy skin, severe pain, trouble breathing, ongoing vomiting, or a racing heartbeat. Emergency help is also needed if you cannot stand safely or are passing more black stools. Symptoms can worsen even after a pause in visible bleeding, so do not wait for the colour to return to normal.

Ask where the bleeding may be coming from, whether you need blood tests or an endoscopic examination, and which medicines should be paused. Ask how to recognise recurrent bleeding and when follow-up should happen after treatment.