Have you ever noticed that your stool is darker than usual when you go to the toilet? It may even have a tarry consistency. It's normal to feel a little scared when you see something like this. But it's not always something to be afraid of. Sometimes it can be caused by something we ate or a medicine we took. However, it can also be a sign of a problem inside our body. So let's understand this.
Why does stool turn black? What are the main causes?
Simply put, we can divide the causes of black stool into two main categories. One is the common causes that are nothing to worry about. The other is the serious causes that we should definitely be concerned about and seek medical advice for.
Take a look at the table below, and you'll get a better idea of this.
| Reasons not to be afraid, often | Serious causes of concern (bleeding inside the organ) |
|---|---|
| Iron supplements: Iron supplements taken for anemia can cause black or dark green stools. This is a common side effect. | Peptic Ulcer: Bleeding from ulcers in the stomach or small intestine. |
| Certain medications: Medicines containing bismuth subsalicylate (e.g. Pepto-Bismol) used for stomach upset. | Esophageal tears (Mallory-Weiss Tear): Esophageal tears occur due to excessive vomiting or coughing, causing bleeding. |
| Dark-colored foods: Blueberries, strawberries, beets, foods with black artificial coloring, blood sausage, etc. | Esophageal Varices: A swelling and rupture of the veins in the esophagus, commonly seen with liver disease. |
| Activated charcoal: Something given as a treatment in cases of poisoning. | Gastritis/Esophagitis: Severe inflammation of the walls of these. |
| Cancers: Cancers that occur in the upper digestive system, such as the esophagus, stomach, or pancreas. |
The most important condition to be concerned about: Internal Bleeding
This is the reason we should be most concerned when our stools are black. Especially if your stools are black, tarry, and have a stronger odor than usual , it is often a sign of bleeding in the upper part of your digestive system (i.e., in the esophagus, stomach, or the first part of the small intestine).
In medical terms, this condition is called Melena . This occurs when the blood in the body mixes with digestive juices and chemically changes, turning it black.
Think about it, if the bleeding occurs in the lower part of the digestive system, like the large intestine, the blood doesn't have time to be digested, so it comes out with the stool in a fresh red color . But when the bleeding occurs in the upper part, the blood has traveled a long way and has been digested before it comes out. That's why it turns black.
Stomach Ulcer (Bleeding Ulcer)
The main cause of melena is peptic ulcers. These are wounds that form in the lining of the stomach or small intestine. When these wounds start to bleed, the stool turns black. There are two main causes of peptic ulcers:
- A bacterial infection called H. pylori .
- Prolonged or excessive use of painkillers, especially NSAIDs (Nonsteroidal anti-inflammatory drugs) (e.g. Aspirin, Ibuprofen, Diclofenac).
Other symptoms of this condition may include stomach pain, bloating, nausea, and sometimes vomit that looks like coffee grounds.
Esophageal and Gastric Cancers
Although rare, black stools can be an early sign of cancer of the esophagus or stomach. This is caused by bleeding from the cancerous growths. In addition to black stools, it is important to watch out for other symptoms such as:
- Difficulty swallowing
- Weight loss for no reason
- Chest pain or inflammation
- Frequent stomach upset, nausea
- Feeling full even after eating a little
If you have one or more of these symptoms along with black stool, see your doctor without delay .
When should you see a doctor?
If you are not 100% sure that your black stool is caused by iron supplements, it is best to see a doctor for advice. It is especially important to seek medical advice immediately if you have any of the following symptoms. You may need to go to the Emergency Department (ETU) of your nearest hospital.
| Warning signs that require urgent attention | |
|---|---|
| Vomiting with blood | If your vomit turns red or black, like coffee grounds. |
| Severe dizziness or loss of consciousness | Blood pressure can drop due to internal bleeding, which can cause: |
| Difficulty breathing | If you feel difficulty breathing for a few minutes. |
| Severe stomach pain | Sudden or unbearable stomach pain. |
| Paleness and extreme fatigue | If your skin is pale and you feel more tired than usual. |
What kind of tests will the doctor do?
When you see a doctor, they will listen carefully to your symptoms and, if necessary, refer you for a stool sample test (Stool for Occult Blood test). This can detect whether there are any invisible blood particles in your stool. If bleeding is confirmed, they may also recommend something like an endoscopy to find the cause.
Take-Home Message
- Black stools are not always a sign of a serious illness. Iron supplements or certain foods can also cause this.
- However, if the stool is black, tarry, and has a strong odor (Melena), it is a strong sign of bleeding in the upper digestive tract.
- In addition to black stools, if you have other symptoms such as stomach pain, dizziness, vomiting blood, or difficulty breathing, see a doctor without delay .
- If you are unsure of the cause, it is wise to consult a doctor and clear your doubts, rather than guessing. Your health is the most valuable thing.
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