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Dr. Das, MD
Dr. Das, MD, Doctor
Category: Medical
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Experience:  MBBS, MD, with wide experience in all aspects of medical treatment, including cancer therapy.
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My friend's 75 year old dad vomited blood lumps on the 1

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My friend's 75 year old dad vomited blood lumps on the 1 Nov. He was admitted to the hospital on the same day and his hemoglobin level was 4. After endoscopy, it was confirmed gastric ulcer, was put on drip and fasted till today 7 Nov.
His hemoglobin today has increased to 8 after 6units blood transfusion. However, his stool today is still black in color, does this mean there's still internal bleeding?
How long/days will the stool remain black before returning to normal colour if there's not more bleeding?
Welcome and thank you for the question.
Yes, the black color of the stool indicates that he is still bleeding inside.
Without bleeding, the stool returns to normal color within 24-48 hours. It takes that that time for food (or blood) in the stomach to reach the rectum. The black color would gradually decrease within this time.
Customer: replied 3 years ago.

Hi Dr. Das,

Tks for the reply. What are the options for gastric ulcers besides surgery?

If the patient passed motion only on 1 Nov and then again on 6 Nov and 7 Nov, would it be that the blood from previous bleeding hasn't quite cleared up yet or it would have cleared by 6 Nov?

Reason being, the doctors are divided in the next treatment, some say surgery is the only option but the family is concerned due to the age factor.

Tks !!

if the patient has not passed motion since 1st Nov, then the black stool on the 6th and 7th could be collected stools with earlier blood. It is possible that the bleeding has decreased and the next stools that will pass will be less black than now. It will be better to wait for the next 24 hours and see if he passes black stools again.
If he is bleeding, an endoscopy (gastroscopy) will need to be performed. The bleeding areas can be sealed with Injection therapy combined with Thermal coagulation. In some cases, hemoclips may need to be used.
It is only when endoscopic treatment fails that surgery needs to be considered.
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Customer: replied 3 years ago.

Hi Dr. Das,

May I know what other symptoms to watch for that indicates gastric bleeding besides black stool?

The patient has not been allow to take any food since 1 Nov and is still on drip. Is it possible for the patient to eat any food?

The primary doctor feels that from the endoscopy 1 week ago and the recent black stool (6 and 7 Nov. No motion since after 7 Nov.), surgery is required as the bleeding would have stopped by now.

The patient will be transferring to another hospital today. Any advise will be appreciated.


If ther is continued gastric bleeding, he will have all the signs of blood loss - pallor, fast pulse rate, low BP. His hemoglobin level will increase with blood transfusion but will fall within 2-3 days if there is continued bleeding. If the hemoglobin level is maintained at a constant rate without further blood transfusion, then it rules out active bleeding.
It will be better for the patient not to eat anything - it allows the bleeding ulcer to heal.
Please ask for a repeat hemoglobin test as also a repeat endoscopy before you decide on surgery.
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