[39F] With black tarry stools and abdominal pain

Patient Description

A 39-year-old female presents with black, tar-like stools and severe sharp abdominal pain, rated 7-8/10, which began recently. The pain was somewhat relieved by drinking Pepsi. She also reports nausea, vomiting, and mild weakness, feeling unsteady while walking. Diarrhea has been occurring off and on for the past month, with unusual color and smell, but no specific food triggers. There is no recent travel, alcohol consumption, or use of medications like NSAIDs or aspirin. She manages type 1 diabetes with NovoLog and takes Belsomra and ibuprofen occasionally. The patient reports episodes of diarrhea 2-3 times a month, with one instance of incontinence during sleep.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possibilities to consider:

  1. Gastrointestinal Bleeding: Black, tar-like stools can indicate bleeding in the upper part of your digestive tract. This could be due to ulcers or other conditions. It's important to address this immediately, as it can lead to significant blood loss.

  2. Medication Effects: While ibuprofen is helpful for migraines, it can sometimes cause stomach irritation or ulcers, leading to bleeding.

  3. Diabetes Complications: Your type 1 diabetes can complicate other health issues, making it crucial to monitor symptoms closely.

These conditions require prompt medical attention. Testing might include blood tests, stool tests, or imaging studies to determine the cause of the bleeding.

What you can do

  • Seek Immediate Medical Attention: Please visit an emergency room or urgent care as soon as possible. If you feel too weak to travel, call 911 for assistance.

  • Avoid Certain Medications: Until you see a doctor, avoid taking ibuprofen or other NSAIDs, as they can worsen stomach issues.

  • Monitor Symptoms: Keep track of any changes in your symptoms, such as increased weakness, dizziness, or changes in stool color.

  • Stay Hydrated: Try to drink small sips of water or an electrolyte solution to stay hydrated, especially if you're experiencing diarrhea.

Remember, it's crucial to get evaluated by a healthcare professional to receive the appropriate care.

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4 mo ago

Top picked over-the-counter products for Irritable Bowel Syndrome: American College of Gastroenterology Guidelines

People Also Ask


What causes black, tar-like stools and should I be concerned?

Black, tar-like stools, known as melena, often indicate bleeding in the upper gastrointestinal tract, such as from an ulcer. This is a serious condition that requires immediate medical attention to prevent significant blood loss.


Can ibuprofen cause gastrointestinal issues even if taken occasionally?

Yes, ibuprofen, even when taken occasionally, can cause stomach irritation or ulcers, which may lead to gastrointestinal bleeding. It's important to use it cautiously, especially if you have a history of stomach issues.


How can type 1 diabetes affect gastrointestinal health?

Type 1 diabetes can affect gastrointestinal health by causing conditions like gastroparesis, which slows down digestion, or by increasing the risk of infections and ulcers due to poor blood circulation and nerve damage.


What immediate steps should I take if I suspect gastrointestinal bleeding?

If you suspect gastrointestinal bleeding, seek immediate medical attention by visiting an emergency room or calling 911. Avoid taking NSAIDs like ibuprofen, monitor your symptoms, and try to stay hydrated with small sips of water or an electrolyte solution.


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