Which sign is listed as a manifestation of GI bleeding, often presenting as material in vomit?

• A. Bright red emesis
• B. Pale stool
• C. Severe dehydration
• D. Coffee-ground emesis

Answer: (D)

When GI bleeding is present, vomitus can take on a distinctive, dark appearance due to blood that has been in the stomach and mixed with gastric acid. This is coffee-ground emesis. The iron in the blood is oxidized by stomach acid, turning the material into a brownish, granular texture that looks like coffee grounds. This indicates the blood has been in the stomach long enough to be partially digested, often from an upper GI source such as a peptic ulcer or gastritis. In contrast, bright red vomit suggests fresh, actively bleeding blood, pale stool points to issues outside of acute GI bleeding in the stomach, and severe dehydration describes a consequence rather than a direct sign of the vomitus itself. So coffee-ground emesis best represents a manifestation of GI bleeding seen in vomit.