My poop is black in color for the past few days. What tests should I perform?

Question

Hi doctor, I have headache on the sides of my head, lower neck stiffness, mild chest tightness, difficulty in swallowing, mild burning sensation on the scalp and face, which spreads to hands and legs at times.The main concern is that my fecal matter has been black for the past five days. I am not taking any iron supplements, and I have quit eating non-vegetarian food a month back. Is it a concern? Do I need to do any investigations?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query, and I understand your concern.

Black stool needs investigation unless you eat foods that can turn your stool black in color like dark chocolate, cookies or biscuits, blueberries, or taking iron supplements or bismuth-containing indigestion medicine. If you remember having any of the food mentioned above or supplements, further investigations are not needed. But if there is no such history, I would suggest the best approach to undergo medical tests to identify the cause. You have mentioned that it is present for five days. The cause of the black-colored stool is due to the blood in the stool after excluding the above reasons that can change the stool color to black. It is called melena. The black color is caused by enzymes breaking down and digesting the blood as it moves through the GI (gastrointestinal) tract. If the blood is coming from the lower gastrointestinal tract, like in cases of hemorrhoids, then stool appears red or maroon, and it is fresh blood compared to melena. The common causes include (anything which damages the mucosal lining of the stomach and upper part of the small intestine) like peptic ulcer disease, gastritis, GERD (gastroesophageal reflux disease), and chronic medication like NSAIDs (non-steroidal anti-inflammatory drugs).

Please answer the following questions:

1) Have you ever taken NSAIDs medicine for an extended period before?

2) Do you experience any pain in the epigastric region, bloating, retrosternal chest pain, food regurgitation, burping, indigestion episodes?

3) Are you a chronic smoker, or do you take alcohol regularly?

4) Do you experience any nausea or vomiting?

5) Have you had any previous tests for Helicobacter pylori infection?

I would suggest you visit a medical gastroenterologist to assess your condition and identify the source of the bleeding (if bleeding in the upper GI tract is the cause) so that proper medical investigations and treatment can be started at the earliest.

Please reply to the above questions to guide you better and further.

Take care.

Thanks.

Answer 2

Hello,

Welcome back to icliniq.com.

Thanks for the reply. It is good to read that you do not have any chronic history, which I asked in the medical history questions. Wait for two days and watch whether the stool color changes to normal stool color. If it persists for another two days, it needs medical evaluation, and you should make an appointment with a local gastroenterologist to get a medical opinion about it. The doctor may ask you relevant medical history, family history, any bleeding disorder to rule out the possible causes. Based on the medical history your doctor may recommend basic blood tests like Hb (Hemoglobin), RBC (red blood cells count) count, platelet count, and relevant other investigations if needed.

I hope I can guide your query. Do follow up if necessary and if you want to share any medical reports (in case you undergo any medical tests related to it). I wish it to get normal at the earliest.

Thanks and regards.