MELAKA, July 13 — A black stool can mean nothing at all, or it can be the body’s first warning sign of life-threatening internal bleeding from the upper gastrointestinal (GI) tract.
The difference, according to Dr Quek Yeow Ling, Consultant General Surgeon at Oriental Melaka Straits Medical Centre, comes down to colour, texture, smell and what else is happening to the body.
“Certain foods such as seaweed, black sesame and blueberries, as well as iron tablets, can make stools look darker. But bleeding is more likely if stools are jet black, sticky and tar like, extremely foul smelling, and accompanied by dizziness, weakness or vomiting blood,” he said.
Upper GI bleeding, from the oesophagus, stomach or duodenum, is a medical emergency. Severe blood loss can trigger a drop in blood pressure, shock and death if not treated in time.
A 2025 study published in Cureus tracked 293 adults treated for upper GI bleeding at Hospital Canselor Tuanku Muhriz in Kuala Lumpur. Of those, 18.4 per cent required intensive care, 7.8 per cent experienced rebleeding and 4.8 per cent died in hospital, with most patients aged 70 and above.
Vomiting blood, whether bright red or resembling coffee grounds, is another warning sign. So are sudden dizziness, fainting, a racing heartbeat, shortness of breath, cold and clammy skin and upper abdominal pain.
“If you are unsure, it is safer to get checked at a clinic or emergency department rather than assume it is due to food or supplements,” Dr Quek said.
Stomach and duodenal ulcers are the most common cause. Gastritis, Mallory Weiss tears from severe vomiting, oesophageal varices linked to liver disease, long term painkiller use and H. pylori infection are also known triggers. Oesophageal or stomach cancer, though less common, can also be responsible.
People on long term painkillers, aspirin or blood thinners are among those most at risk. So are heavy drinkers, smokers, older patients and those on multiple medications. A history of ulcers, liver disease or untreated H. pylori infection also raises the risk.
“Do not wait at home or try to self-medicate. Go straight to the nearest emergency department, especially if there is vomiting of blood, black tarry stools, or dizziness and weakness,” Dr Quek warned.
At the hospital, doctors check vital signs and run blood tests to assess blood loss and stability. The main diagnostic tool is an upper GI endoscopy, or OGDS. A thin flexible camera is passed through the mouth to locate the source of bleeding. In many cases, it can be stopped during the same procedure using clips, injections or heat.
Treatment may include intravenous fluids and blood transfusions, acid reducing medications such as proton pump inhibitors, drugs to reduce vein pressure for liver disease patients and radiology procedures to seal off bleeding vessels. With advances in endoscopy and radiology, most patients no longer need surgery.
Surgery is considered only when other methods fail, when severe rebleeding persists or when complications such as a perforated ulcer or certain tumours arise.
Dr Quek advises using painkillers only when necessary and taking stomach protecting medication if on long term aspirin or blood thinners. Those with a history of ulcers or persistent indigestion should get tested for H. pylori. Cutting back on alcohol, quitting smoking and keeping chronic conditions in check can also lower the risk.
Upper abdominal pain, black stools, blood in vomit or unexplained fatigue should not be ignored, he said, adding that early recognition and prompt treatment of upper GI bleeding can save lives.
About Dr Quek Yeow Ling
Dr Quek Yeow Ling graduated from Universiti Putra Malaysia in 2007 and obtained his Master of General Surgery from Universiti Kebangsaan Malaysia in 2015.
He is experienced in the diagnosis and surgical management of hernias, gallbladder disorders, colorectal diseases, breast conditions, thyroid diseases, and other general surgical conditions. Committed to delivering patient-centred care, Dr. Quek combines modern surgical techniques with clear communication to help patients achieve faster recovery and better long-term outcomes.
About Oriental Melaka Straits Medical Centre
Established in 2015, Oriental Melaka Straits Medical Centre (OMSMC) is an MSQH-accredited tertiary care hospital with a 300-bed capacity. OMSMC is operated by Melaka Straits Medical Centre Sdn Bhd (MSMC), a healthcare subsidiary of OHB, a public-listed company on Bursa Malaysia. As the flagship hospital under the Group’s healthcare segment, OMSMC is committed to delivering high-quality, patient-centred healthcare services to the community and beyond.
Strategically located in the scenic coastal area of Klebang, Melaka, OMSMC offers a conducive environment for healing and recuperation — away from the bustle of the city while remaining easily accessible to both local and international patients.
Over the years, OMSMC has earned multiple recognitions for healthcare excellence, patient safety, and service quality, including recognition in the Global Hospital Rating 2025 by Newsweek and Statista, inclusion among Asia’s Top Private Hospitals & Clinics 2026, and consecutive Healthcare Asia Awards for Patient Safety Initiative of the Year – Malaysia. In 2024, the hospital also achieved its third consecutive full four-year accreditation under the Malaysian Society for Quality in Health (MSQH) 6th Edition standards.
OMSMC is supported by a multidisciplinary team of experienced specialists, allied health professionals, and dedicated nurses committed to delivering holistic and personalised care. Many of its nurses are graduates of the Oriental Nilam College of Nursing and Health Sciences Sdn Bhd, an OHB subsidiary located within the same medical hub, ensuring a strong pipeline of well-trained and compassionate healthcare professionals.
The hospital provides a comprehensive range of medical specialties and subspecialties, including cardiology, cardiothoracic surgery, electrophysiology, gastroenterology & hepatology, dermatology, geriatric medicine, general and minimally invasive surgery, orthopaedics, hand & microsurgery, nephrology, neurology, obstetrics & gynaecology, paediatrics, respiratory medicine, and other multidisciplinary specialties.
OMSMC continues to invest in advanced medical technologies and innovative healthcare solutions, including robotic-assisted knee replacement surgery, enhancing surgical precision, personalised treatment planning, and post-operative recovery outcomes for patients. Equipped with modern operating theatres, advanced catheterisation laboratories (Cathlabs), and comprehensive diagnostic and interventional imaging services, the hospital offers a wide spectrum of diagnostic, interventional, surgical, and rehabilitative care.
Key facilities and services include:
- Advanced Operating Theatres & Cathlabs
- Robotic-Assisted Knee Replacement Surgery
- Diagnostic & Interventional Imaging Services
- Day Care Endoscopy
- Health Screening Centre
- Haemodialysis Centre
- Rehabilitation Department
- Laboratory Services
- Pharmacy & Satellite Pharmacy Services
- 24-hour Emergency Department
In line with its commitment to sustainability and responsible healthcare, OMSMC is also the first hospital in Melaka to join the Global Green and Healthy Hospitals (GGHH) network, reflecting its ongoing Environmental, Social, and Governance (ESG) initiatives, including sustainable healthcare practices and future-focused green initiatives.
Beyond acute medical care, OMSMC also operates Star Joy Care Centre Sdn Bhd, providing elderly daycare and home care services to support senior citizens through personalised care, rehabilitation support, and assisted daily living services in a safe and comfortable environment.
Patients and visitors also benefit from a range of convenience facilities, including a retail pharmacy, cafeteria, convenience store, concierge services, EV charging stations, and ample parking spaces.
For more information, please visit www.orientalmedical.com.my
