Black stools — Patient information · Ruqelo Health
General practice·General practice
Black stools
Ruqelo Health — Take to your appointment
Educational summary — not medical advice. Discuss with your healthcare provider.
Informed by recognized medical guidance
Overview
Black stools (also called melena) means your poop looks black, tarry, and sticky. This often happens when there is bleeding in the upper part of your digestive system — the stomach or the first part of the small bowel. The blood changes color as it travels through your gut. However, black stools can also be caused by certain foods or supplements, so it does not always mean bleeding.
Key facts
Black stools can be a sign of bleeding in the upper digestive tract, but they are not always serious.
Certain foods (like black licorice or blueberries) and supplements (like iron) can turn stools black.
If black stools happen with symptoms like dizziness, vomiting blood, or severe belly pain, you need emergency care.
Questions about this article
Your doctor can find the cause with simple tests and often treat it effectively.
Black stools are fairly common, especially in people who take non-steroidal anti-inflammatory drugs (NSAIDs) or who have stomach ulcers. However, not everyone with black stools has a serious problem.
Black stools can affect anyone, but they are more common in people over 60, those who take NSAIDs or aspirin regularly, people with heavy alcohol use, and those with a history of stomach ulcers or acid reflux.
Symptoms
Call emergency services immediately if you notice:
Black stools along with vomiting blood (either bright red or like coffee grounds)
Feeling faint, dizzy, or very weak
Rapid heartbeat or shortness of breath
Severe belly pain that does not go away
See a doctor urgently (same day) if you notice:
⚠Black stools without other symptoms, especially if you take NSAIDs or aspirin regularly
⚠Black stools that continue for more than a day or two, even if you think the cause is food
⚠Black stools with mild belly pain or heartburn that concerns you
Common symptoms
Stools that look black, tarry, and sticky, with a foul smell
Sometimes a feeling of fullness, burning, or mild discomfort in the upper belly
Symptoms in children
Black stools in children may be caused by swallowed blood from a nosebleed or from certain foods like dark berries or iron supplements.
If your child has black stools along with belly pain, vomiting, or unusual tiredness, see a doctor.
Symptoms in older adults
Older adults are more likely to have black stools from bleeding ulcers, especially if they take blood thinners or pain relievers.
Black stools in older adults can be a sign of a more serious condition, so they should always be checked by a doctor.
Causes
Main causes
Peptic ulcers (sores in the stomach or small bowel lining)
Gastritis (inflammation of the stomach lining)
Esophageal varices (swollen veins in the food pipe, often from liver disease)
Mallory-Weiss tear (a tear in the food pipe from severe vomiting)
Certain foods like black licorice, blueberries, or dark chocolate
Iron supplements or medicines containing bismuth (like some stomach remedies)
Less commonly, a tumor or cancer in the stomach or small bowel
Risk factors
Taking NSAIDs (like ibuprofen, naproxen) or aspirin regularly
Heavy alcohol use
Smoking
Infection with H. pylori bacteria
History of peptic ulcers or gastritis
Liver disease
When to see a doctor
See a doctor urgently if:
You have black stools and any emergency symptoms (like vomiting blood, feeling faint, rapid heartbeat). Call your local emergency number.
You have black stools after a recent injury to the belly or after a procedure like endoscopy.
Book a routine appointment if:
You notice black stools and think it might be from food or supplements, but it does not go away in a day or two.
You have black stools and are worried, even if you have no other symptoms.
If you recently ate black licorice, blueberries, or took iron supplements and your stools are black, it is likely harmless. However, if you are not sure, it is always best to check with a doctor.
Diagnosis
Your doctor will ask about your symptoms, diet, and medicines. They may press on your belly and check your pulse and blood pressure. A simple test on a stool sample can check for hidden blood. If bleeding is suspected, you may need a procedure to look inside your digestive system.
Tests that may be done
Stool test (checks for hidden blood)
Blood tests (to check for anemia or liver problems)
Upper endoscopy (a thin, flexible tube with a camera is passed down your throat to look at your stomach and small bowel)
Sometimes a CT scan or other imaging
What to expect at your appointment
If you see your doctor for black stools, they will first check if you are stable. You might be asked to stop certain medicines and come back for follow-up. The main test, an endoscopy, is usually done with a light sedative so you are relaxed. It takes about 15–30 minutes. Most people go home the same day.
Treatment
Treatment for black stools depends on the cause. If it is from a bleeding ulcer, the goal is to stop the bleeding and heal the ulcer. If the cause is a medicine, you may need to stop or change it. If it is from food or supplements, no treatment is needed.
Self-care at home
Stop taking NSAIDs or aspirin if your doctor advises it (do not stop blood thinners without talking to your doctor).
Avoid alcohol and spicy foods until the cause is found.
If you take iron supplements and your stools are black, that is normal — but check with your doctor if you are unsure.
Medical treatments
For bleeding ulcers or gastritis, doctors often prescribe medicines to reduce stomach acid and protect the lining. If an infection with H. pylori is found, you may receive antibiotics. If bleeding is active, doctors can often stop it during an endoscopy using small tools or clips. In some cases, blood transfusions may be needed.
When is surgery considered?
Surgery is rarely needed for bleeding ulcers. It may be considered if bleeding cannot be stopped with endoscopy or if there is a tear or other structural problem.
Living with this condition
After treatment, your stools should return to normal. Keep track of your stool color and any symptoms. If you have had an ulcer, your doctor may recommend a follow-up endoscopy to make sure it is healed.
Lifestyle tips
Avoid NSAIDs and aspirin unless prescribed by your doctor.
Limit alcohol and quit smoking – these can worsen ulcers.
Manage stress with relaxation techniques or counselling.
Diet and exercise
Eat smaller, more frequent meals. Avoid very spicy, acidic, or fried foods while your stomach heals. Gentle exercise like walking is fine, but avoid heavy lifting if you are recovering from a bleeding episode.
Mental health and emotional wellbeing
Having black stools can be scary. It is normal to feel anxious about what is happening. Talk to your doctor about your concerns. Most causes of black stools are treatable, and you can get back to your normal life.
Prevention
You can reduce your risk of black stools from bleeding by avoiding overuse of NSAIDs and aspirin, limiting alcohol, and not smoking. If you have an H. pylori infection, completing treatment can prevent ulcers. Always follow your doctor's advice about medicines.
Vaccines
No vaccine directly prevents black stools.
Screening programmes
If you have risk factors like long-term NSAID use or a family history of stomach cancer, your doctor may recommend periodic endoscopy. This is not routine for everyone.
Complications
If left untreated
Severe blood loss leading to anemia (low red blood cells) – causing fatigue, pale skin, and shortness of breath
Shock from rapid blood loss – with dizziness, confusion, and low blood pressure
Bleeding that recurs or does not stop, requiring emergency treatment
Long-term outlook
Most causes of black stools are very treatable. With proper care, ulcers heal, and bleeding stops. Even when the cause is more serious, early diagnosis gives the best chance for successful treatment. Your doctor will help you every step of the way.
Find support
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 8, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.
