Which sign suggests gastrointestinal bleeding in a patient taking NSAIDs?

• A. Nosebleed
• B. Black tarry stools
• C. Rash
• D. Hair loss

Answer: (B)

Bleeding in the GI tract from NSAID use shows up in stool as melena—black, tarry stools formed when digested blood passes through the GI tract. NSAIDs irritate the stomach lining and reduce protective prostaglandins, increasing ulceration and bleeding risk, especially in the upper GI tract. Therefore, black tarry stools are the clearest sign of a GI bleed in someone taking NSAIDs. Nosebleeds, rash, or hair loss are not direct indicators of a GI bleed and don’t reflect bleeding in the digestive tract. So the presence of black, tar-like stools best signals GI bleeding in this context.