ETHOS

I have had black, tarry bowel movements for the past few days.

Patient

Hi there, I've been experiencing some concerning symptoms lately, and I'm hoping to get some advice on what might be going on and what I should do next.

Triage Assistant

I can help with that. Can you tell me where it hurts?

Patient

Actually, I haven't been feeling any pain, but there's something unusual happening with my bowel movements that has me worried.

Triage Assistant

Let's start by understanding your symptoms better. How often do you have a bowel movement (BM), and when was your last BM?

Patient

I usually have a bowel movement once a day. My last one was this morning.

Triage Assistant

Do you have to strain to have a bowel movement (BM)?

Patient

No, I don't usually have to strain. They come out fairly easily.

Triage Assistant

Does your rectum hurt when the stool comes out?

Patient

No, my rectum doesn't hurt when I have a bowel movement.

Triage Assistant

Are your stools hard?

Patient

No, my stools are not hard. They have a normal consistency.

Triage Assistant

Has there been any blood on the toilet tissue or on the surface of the bowel movement?

Patient

No, I haven't noticed any actual blood on the toilet tissue or on the surface of the bowel movement. But there's something different about them.

Triage Assistant

Is this change in your bowel movements a new problem for you? If not, how long have you had this problem?

Patient

Yes, this is a new problem. It's been happening for the past few days, and it really has me concerned.

Triage Assistant

Have there been any recent changes in your diet or hydration? How much fluids are you drinking on a daily basis, and how much have you had to drink today?

Patient

My diet and hydration levels have been pretty consistent, nothing out of the ordinary. I usually drink about 2 liters of water daily, and that's been the same today as well.

Triage Assistant

Have you been taking any new medications recently, or are you taking any narcotic pain medicines?

Patient

No, I haven't started any new medications, and I'm not taking any narcotic pain medicines.

Triage Assistant

Have you been using any stool softeners, laxatives, or enemas? If yes, what, how often, and when was the last time?

Dispositions

  • Call EMS 911 Now

  • See More Appropriate Protocol

  • Go to ED Now

  • Go to ED/UCC Now (or to Office With PCP Approval)

  • Go to Office Now

  • See in Office Today

  • See in Office Today or Tomorrow

  • See in Office Within 2 Weeks

  • Home Care

  • Triage result should be Go to ED Now.

  • First aid is not applicable.

  • Some assessment questions asked.