Black Stool: Is Your Stool Black? When to Worry and Why

Black stools might often be an alarming symptom that usually indicates the problem is related to the digestive system. The bowel color change may not always mean something serious, but it must be recognized and consulted medically if needed. This article discusses the potential causes of black stools, when one needs to be concerned, and what steps can be taken to solve the issue.
What are Black Stools?
Black stools, medically referred to as melena, are the condition characterized by dark, sticky, or black-colored feces. This change in color is typically because of digested blood in the gastrointestinal system, especially in the upper digestive tract. While it can happen if the patient is generally unwell, black stools should be promptly seen by a healthcare provider for hearing the reasons.
Generally, black stool indicates the likelihood of possible gastrointestinal bleeding, which may result in serious complications if left unattended. The distinctive discoloration is a result of various factors, including dietary choices and underlying medical conditions. In general, blood turns black as it passes through the digestive system before being excreted in the feces.It is important to know the mechanisms involved in assessing and getting treatment on time. Identifying and managing background diseases like ulcers, gastritis, or certain cancers is crucial for identifying the exact cause and effective treatment.
Black Stool Symptoms
Black stools, or tarry stools, are the primary symptoms many patients will experience, but they may also have a number of other digestive symptoms, including the following:
- Pain or discomfort in the abdominal area
- Nausea and vomiting in some severe upper gastrointestinal bleeding cases
- Heartburn or dyspepsia (indigestion)
- Bowel habits that are not normal for the individual
- Fatigue and weakness generally
- Dizziness or fainting, since heavy loss of blood may lead to lower blood pressure
- Severe, unexplained weight loss
- Fever, especially in some infection cases
Note: Symptoms of black stools might be changed based on the specific cause. Additional symptoms may include stomachache, black tongue, ringing or buzzing sounds in the ears, bright red blood in stools, weakness, trouble breathing, pale skin, diarrhea, and chest pain.
Black Stool Reasons
The upper parts of the digestive system usually refer to the stomach and upper parts of the small intestine—the duodenum. Bleeding in this area is what gives rise to melena. It could also be from the lower esophagus in some cases. Very rarely, it may be the cause coming from the lower small bowel or upper large bowel. Some of the common causes of black stool include:
- Ulcer formation: Ulcers are open sores on the digestive tract’s lining, causing symptoms like stomach burning, indigestion, heartburn, and general unwellness. Bleeding ulcers can lead to severe symptoms, including black, sticky, and tarry stools. If these stools are accompanied by any of these symptoms, it’s crucial to consult a doctor as soon as possible.
- Gastrointestinal bleeding: Upper gastrointestinal bleeding can result from various conditions such as ulcers, gastritis, esophagitis, Mallory-Weiss syndrome, and stomach cancer, which might lead to black stools. These serious conditions often include other gastrointestinal symptoms. If stools are black and tarry for a few days, accompanied by stomach aches and vomiting, it is crucial to seek medical help immediately. These conditions can lead to serious gastrointestinal symptoms.
- Gastrointestinal Cancers: Gliacoma, a more uncommon bleeding source, can also be due to colorectal cancer in the esophagus, stomach, duodenum, and pancreas, as they can also erode the GI tract lining and change fresh blood in the stool to tar (Black stool).
- Consuming dark foods: Poop turning black may be due to certain foods, such as black liquorice, blueberries, beets, dark beer, and dark chocolate cookies, which can cause it to change from its usual brown color to a blacker one, especially if no additional gastrointestinal symptoms have been observed.
- Taking iron supplements: Iron supplements are primarily used to treat anemia, a condition in which there are insufficient red blood cells in the body, resulting in general fatigue and weakness. However, it may also bring in adverse effects, including nausea, constipation, and black stools. One must consult the doctor if they have experienced these side effects because there are various iron supplements that may be more stomach-friendly.
- Bismuth-containing medications: Medicines that contain bismuth subsalicylate—like Pepto-Bismol—will turn the stools black. If too much bismuth subsalicylate is ingested for a long time, the tongue and teeth may also turn black.
- Gastrointestinal bleeding: Upper gastrointestinal bleeding can result from various conditions such as ulcers, gastritis, esophagitis, Mallory-Weiss syndrome, and stomach cancer, which might lead to black stools. These serious conditions often include other gastrointestinal symptoms. If stools are black and tarry for a few days, accompanied by stomach aches and vomiting, it is crucial to seek medical help immediately. These conditions can lead to serious gastrointestinal symptoms.
- Esophageal varices: Esophageal varices refer to swollen veins in the esophagus. This condition is often associated with cirrhosis or advanced liver diseases that may rupture and lead to red or black stools. If anyone knows about liver disease and observes black stools, muscle cramps, abdominal pain, unexplained loss of weight, or jaundice, they should contact a doctor immediately.
Diagnosis of Black Stools
Black stool diagnosis involves the following approaches:
- Physical examination and medical history evaluation: The doctor performs a thorough physical examination to identify possible causes of black stools. This includes an abdominal examination to check for abnormalities and a rectal examination to assess for bleeding in the lower gastrointestinal tract. The medical history evaluation includes questions about symptoms, medical history, medication use, dietary habits, and family history. By gathering this information, doctors can determine the most appropriate diagnostic tests to treat the condition. This all-inclusive approach enables the doctors to diagnose and treat black stools effectively.
- Laboratory tests: Doctors commonly order a series of laboratory tests in order to acquire more specific data. These include:
- Complete blood picture, or CBC: This can assess the presence and severity of bleeding.
- Fecal occult blood test: This will confirm whether the black color of the stool is due to blood loss or other causes.
- Stool culture: Typically, this will be for the detection of pathogenic bacteria or parasites.
- Helicobacter pylori test: Done to diagnose the H. pylori infection.
- Imaging tests: Doctors might advise the following imaging studies:
- Esophagogastroduodenoscopy (EGD): Doctors may perform an esophagogastroduodenoscopy (EGD) to inspect the lining of the esophagus, stomach, and upper intestine by inserting a flexible tube with a camera down the throat.
- Colonoscopy: Used to view the lower gastrointestinal tract; that is, the colon and rectum.
- Endoscopy: Used to view the upper gastrointestinal tract, that is, the esophagus, stomach, and duodenum.
- Capsule Endoscopy: This innovative method uses swallowing a small camera pill that captures images from the small intestine as it passes through.
- Upper Gastrointestinal Series: An X-ray examination visualizing the upper digestive system.
Black Stool Treatment
The treatment for black stool will be varied from person to person based on the underlying cause and the patient’s condition. The following are the common treatment approaches that are suggested for the patient’s experience with the black stools:
- Supportive care: Doctors diagnose patients who develop black stools and institute therapy, which may involve administering intravenous fluids and/or blood transfusions and ICU intervention. Sometimes, black stool just resolves when the offending cause in the form of dark-colored food ingestion or iron supplements is omitted for a few days.
- Dietary changes: Post-evaluation by a doctor, black poop home remedies are to avoid dark and acidic food items, increase the amount of fluids, increase dietary fiber, and use probiotics and herbal remedies in the form of ginger, peppermint, and turmeric. Herbal supplements are used under consultation with a doctor, as other drugs may lead to a dangerous interaction.
- Physical activities: Exercise helps in enhancing well-being and reducing the stress influence on digestive health.
- Bleeding cessation: Black stools are treated to prevent further blood loss by stopping active bleeding. Techniques used during an upper endoscopy include electrocautery, medication injection, placement of clips or bands on blood vessels, and stitching in some cases. These techniques help seal the wound and prevent further bleeding.
- Medications: Drugs such as proton pump inhibitors are prescribed for ulcers, inflammation, or an erosion of the lining in the gastrointestinal tract. Antibiotics are given to treat infections as the root cause, with an aim to eliminate the underlying infection.
- Surgery: In severe cases, surgery may be required to repair a bleeding ulcer or remove a cancerous tumor.
When Should You Worry About Black Stool?
Immediately consult a doctor if any of the following conditions are accompanied by black or tarry stools:
- Intense abdominal pain
- Vomiting blood
- Lightheadedness or dizziness
- Fainting
- Shortness of breath
- Weight loss
- Fever
These conditions might be indicative of considerable blood loss, and immediate medical intervention is required. It is best to check with the gastroenterologists under those circumstances when one is having black stools that do not fade after a couple of days along with one or more worrying features.
Conclusion
Moreover, black stool can be a symptom of a potentially serious underlying health condition, such as upper gastrointestinal bleeding. It is imperative that one consult a doctor promptly to ensure that proper diagnosis and treatment of the underlying cause are received. One can effectively manage the condition and safeguard against complications by being aware of its symptoms and seeking timely medical attention.
Yashoda Hospitals brings advanced gastroenterology services in the diagnosis and treatment of various gastrointestinal disorders, including those associated with black stools. Our gastroenterologists are highly trained and specialized, using state-of-the-art techniques in diagnosis and treatment to ensure efficacious delivery of care with empathy.
Have any questions or concerns about your health? We’re here to help! Call us at +918929967127 for expert advice and support.
About Author –
Dr. Adi Rakesh Kumar, Consultant Gastroenterologist, Therapeutic Endoscopist & Endosonologist