Dennis: My wife suffers badly from constipation and a hiatus hernia. About three months ago she got some tablets from her niece called Pariet for the hiatus hernia. She didn't tell me about it at the time but evidently her bowel movements were black.

Harry: Well you should always take that seriously because when you pass a black stool you've got to think of bleeding into the guts. So that is something that you should never, never ignore. I hope she went to see a doctor straight away.

Dennis: Yes, we've seen our doctor and he thinks it could be an inflammation of the bowel that caused it.

Harry: Is this your GP that you're speaking about?

Dennis: Yes.

Harry: I think that it is very important that you make an accurate diagnosis. Simply to call it an inflammation of the bowel is not good enough. I don't want to be an alarmist but if she has passed a black stool then you've got find out the cause. For example, it could be related to this hiatus hernia, which could be causing an ulcer with bleeding in her gullet. But there are many other possibilities so really what I would suggest is that you must ask your GP to share the responsibility and send her to a gastroenterologist so that she can be properly examined and you can find out the precise cause. And please don't waste any further time.

Dennis: Thank you doctor.