This topic is about a person with chronic gastroparesis who experienced an unusual episode of vomiting a dark, almost black fluid, and later found a similar dark residue on their stoma. They are feeling well otherwise but are concerned about these symptoms and are seeking advice from others who might have had similar experiences.

Here are some helpful insights and advice:

1. Possible harmless sources of the dark color:
- Foods and drinks like black licorice, blueberries, blackberries, beets, or grape juice can cause dark vomit.
- Certain medications or supplements, such as Pepto-Bismol or oral iron supplements, can also darken vomit or stool.

2. Warning signs that need immediate medical attention:
- Vomit that looks like coffee grounds, which can indicate upper gastrointestinal bleeding.
- Repeated episodes of black vomit or dark ostomy output without consuming dark foods or medications.
- Presence of fresh or streaked blood in vomit or stool.
- Symptoms similar to ulcers or signs of ongoing bleeding.

3. General recommendations:
- Do not delay seeking medical care, especially if your regular doctor is unavailable; consider going to the emergency room.
- Trust your physician's cautious approach and get checked for possible bleeding.
- Keep an eye on the color, volume, and frequency of both vomit and ostomy output.

4. Management ideas to discuss with your gastrointestinal specialist:
- Consider whether anti-emetics or pro-motility drugs are being used, and ask about them if not.
- Digestive enzyme therapy might help improve digestion and reduce vomiting in gastroparesis.
- If symptoms persist, evaluate for ulcers, gallbladder, or bile-duct issues.

5. First-hand experiences from others:
- One person experienced black vomit after a bile-stent change and was advised to return to the hospital if it happened again or if blood was present.
- Another person had black vomit and stool due to an ulcer, while someone else had severe vomiting from a bile-filled cyst near the gallbladder.

The general consensus is that while a single episode might sometimes be related to food or medication, black or coffee-ground vomit is often treated as a sign of possible gastrointestinal bleeding, and it is important to seek medical evaluation promptly rather than waiting.