UrgentEmergency Guide
Dark stools: Red Flags & Emergency Signs
Melaena (black, tarry, offensive-smelling stools) indicates upper gastrointestinal haemorrhage — approximately 500mL of blood loss has occurred by the time stools appear tarry.
🚨 Call 999 / 112 Immediately
- ⚠Black tarry stools with dizziness and rapid heartbeat — significant upper GI bleed
- ⚠Melaena with haematemesis — major upper GI haemorrhage, 999
⚡ See a Doctor Today
- •Melaena on NSAIDs or anticoagulants — peptic ulcer with bleed
- •Dark stools in a patient with liver disease — variceal bleed
High-Risk Combinations
When dark stools occurs together with any of these symptoms, urgency increases significantly:
Conditions to Rule Out Urgently
Peptic Ulcer Haemorrhageurgent
IV PPI; endoscopy within 24 hours; Rockall scoring
Oesophageal Varicesurgent
Terlipressin; IV antibiotics; urgent OGD
When to Call Emergency Services
- →Black tarry stools with dizziness, pallor, or fainting