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Suggest Medical Tests To Rule Out Internal Bleeding

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Posted on Wed, 30 Mar 2016
Question: Do I have to go to ER (Emergency) or I can wait for my already previously scheduled appointment with my doctor (for about a week from now) - I have black stool. Previously I discussed with him my easy bruising and showed him my bruise of concern (It lasted longer than other bruises), but it was OK. (No suspicion of internal bleeding).I do take medications which can cause both bruises and black stools. I would rather wait for the appointment, to be XXXXXXX He knows all my other issues and medications.
Also, if the medication in question can cause black stools, does that mean that in that case blood will not be found? If the cause is not medication (how do we know that?),what procedures/tests have to be done and how is internal bleeding treated.? Will I be hospitalized? Thank you in advance.
P. S. I would like Dr. XXXXXXX Romic, if he is available, to answer, but not necessarily him.(He already knows about black stool, but additional questions came to my mind, after he had given me wonderful answer and I closed discussion.) Thank you to all doctors for their great work.
doctor
Answered by Dr. Panagiotis Zografakis (22 minutes later)
Brief Answer:
The ER is more appropriate

Detailed Answer:
Hello,

black stool might mean gastrointestinal bleeding (usually from the upper part of the gastrointestinal system). Innocent causes may apply, including certain food or iron supplements. A doctor can usually distinguish between black stool caused by bleeding and by other causes. If in doubt, the stool can be tested for the presence of blood.

If it's caused by bleeding then this is an emergency. Severe bleeding may even lead to death if left untreated. You haven't mentioned the drugs you were taking but if you're talking about anticoagulants, aspirin or NSAID then the risk of bleeding becomes higher. There are not any tests to actually prove what caused the bleeding but reason and statistical data prove that using drugs like the ones I've mentioned do cause bleeding.

If you do have gastrointestinal bleeding then endoscopic treatment can be attempted. Hospitalization is the rule. There are cases where hospitalization is not necessary but this is the exception, not the rule. Upper gastrointestinal endoscopy is the first test to order when a patient has black stool. A complete blood count will help to estimate the blood loss so far and blood urea levels may provide clues to ongoing bleeding.

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (2 hours later)
Hello,
your comments are very detailed and helpful. I would still like to know how "a doctor can usually distinguish between black stool caused by bleeding and by other causes," as you said. I have a sample of a stool collected today and would like to know how long it takes to get a result (is it faster if I submit it in ER than if I leave it in the lab? Please, understand, why would I go through the all "painful" ER procedure if there is no bleeding? I know, the risk of waiting is too high...) I have experienced so many side effects from medications that I just like to believe that this is also a false alarm. On the other hand, I am afraid of the worst, and I will go to ER. Longer I wait, higher is the risk. But I do not have or don't know that I have any other symptoms. What are the other symptoms of bleeding that I may recognize?... Thank you very much for your great answer, but I guess I have a severe anxiety of going and finding out the worst... that's why I ask more questions... It's easier for me to have in advance more info about the things like this... I would just hate to be in a hospital...
doctor
Answered by Dr. Panagiotis Zografakis (6 hours later)
Brief Answer:
there are some warning signs

Detailed Answer:
I undestand...

When blood remains in the intestine for long it becomes tarry shiny black in color, liquid and has a characteristic odor. An experienced doctor may identify this odor even when entering the room.

How fast you're going to get the answer depends on the lab. The test does not take long to complete but some labs don't just do the tests right away for various reasons. So you'll have to talk about it with the lab.

The warning signs of ongoing bleeding in the gastrointestinal tract include:
- faintness and postural hypotension or hypotension even when lying down.
- thirst.
- abdominal discomfort like when you're about to have diarrhea.
- symptoms related to the cause of bleeding like a burning pain on the stomach in a bleeding gastric ulcer, etc.

A rising urea accompanies upper gastrointestinal bleeding. The hematocrit may not drop right away, unless the bleeding is too severe.
So now you know the most important points in gastrointestinal bleeding, but you still need the help of a doctor to evaluate them. Unfortunately the knowledge of the signs alone is not enough to assess someone's condition. Experience in their assessment is an absolute requirement.

Best wishes!
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3809 Questions

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Suggest Medical Tests To Rule Out Internal Bleeding

Brief Answer: The ER is more appropriate Detailed Answer: Hello, black stool might mean gastrointestinal bleeding (usually from the upper part of the gastrointestinal system). Innocent causes may apply, including certain food or iron supplements. A doctor can usually distinguish between black stool caused by bleeding and by other causes. If in doubt, the stool can be tested for the presence of blood. If it's caused by bleeding then this is an emergency. Severe bleeding may even lead to death if left untreated. You haven't mentioned the drugs you were taking but if you're talking about anticoagulants, aspirin or NSAID then the risk of bleeding becomes higher. There are not any tests to actually prove what caused the bleeding but reason and statistical data prove that using drugs like the ones I've mentioned do cause bleeding. If you do have gastrointestinal bleeding then endoscopic treatment can be attempted. Hospitalization is the rule. There are cases where hospitalization is not necessary but this is the exception, not the rule. Upper gastrointestinal endoscopy is the first test to order when a patient has black stool. A complete blood count will help to estimate the blood loss so far and blood urea levels may provide clues to ongoing bleeding. I hope you find my comments helpful! You can contact me again, if you'd like any clarification or further information. Kind Regards!