I have nausea, black stools, belly pain and gas. What could it be?

Question

Hello doctor,

I am a female, 58, five feet and ten inches , weight is 239 pounds. I am having nausea every morning. It comes and goes during the day. I also have black stools, belly pain, and gas. I am on Lexapro 10 mg, Pramipexole 3 mg, Lamotrigine 25 mg twice daily and 200 mg once, Meloxicam 15 mg, Metformin 500 mg, Gabapentin 300 mg, and Atorvastatin 40 mg. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

Your symptoms are suggestive of upper gastrointestinal intestinal bleed. Please stop Meloxicam 15 mg tablet immediately. I suggest you take proton pump inhibitor medication like Omeprazole 40 mg tablet straightaway and take preferably cold water. Please check with an accident and emergency department for further care for intravenous proton pump inhibitor, antiemetic medications, and further lab investigations such as complete blood count, bleeding and clotting time, prothrombin time with platelets, APTT (activated partial thromboplastin time), INR (international normalized ratio), stool for occult blood, ultrasound abdomen, complete liver function tests to assess the extent of blood loss through stools. In case of evidence of ongoing bleed, you will require packed cells and urgent upper GI (gastro intestinal) endoscopy for diagnosis and stapling of bleeding esophageal varices. Do not take Aspirin tablets or any other painkillers as they can worsen bleeding inside the gut. Stop alcohol, spicy diet, coffee, and tea. After emergency treatment, I suggest the long list of medications be reviewed to see whether it can be simplified. Thank you and take care. Regards.