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Dr. Abhishek Shukla explained that gastrointestinal bleeding can broadly present in two forms – black stool (melena) or red blood in stool (hematochezia). Black stool occurs when blood has been partially digested while passing through the upper gastrointestinal tract, most commonly due to ulcers, gastritis, or esophageal varices. This digested blood gives the stool its characteristic tarry black appearance, a condition known as melena. In such cases, an upper GI endoscopy is essential to identify the source of bleeding and guide definitive management.

For temporary symptomatic relief, the patient may be given cold milk or antacids such as Digene to neutralize gastric acidity, along with proton pump inhibitors (PPIs) like pantoprazole, which help reduce further bleeding. These are only initial measures while preparing for diagnostic and therapeutic interventions. Stabilization of the patient with IV fluids and monitoring of vital signs is equally important before definitive treatment.

On the other hand, if the patient passes fresh red blood, the source is likely from the lower gastrointestinal tract, commonly piles (hemorrhoids) or fissures. In such cases, a per rectal examination followed by proctoscopy is necessary to localize the lesion and plan further management. Thus, the color and nature of stool provide vital clinical clues in differentiating between upper and lower GI bleeds and help in guiding the appropriate diagnostic pathway.

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