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Black bowel movements - causes and treatment
Contents:
definition
Symptom: Black chair
Causes of black bowel movements
Gastric ulcers and gastritis
Varicose veins in the esophagus and stomach, bleeding in the intestinal area
Other causes of black stool
Stool examinations for diagnosis
Therapy with black stool
Treatment of causes
definition
A black stool is to be understood in the broadest sense of all black discoloration of the feces. If the stool is deep black, foul smelling and slightly shiny, this fell under the name of the so-called Tar chair, which is usually caused by bleeding in the upper digestive tract. Black stool, without the typical optical and olfactory features (odor characteristics), is clearly distinguishable from the tarry stool, as it can be the reason for the change in color also the intake of medicines or certain foodstuffs. The same applies to chair whose color is slightly brownish. The deep black first exudates on the anus observed in every newborn (so-called child or meconium) are not digestive products and therefore can not be equated with black bowel movements.
Black stool is always deep black and not just dark as in the picture shown. (Image: simmittorok / fotolia.com) Symptom: Black chair
Black bowel movement in the form of the tarry chair is caused by hematin in the stool. Hematin is produced by contact of the red blood pigment hemoglobin with gastric acid due to the oxidation of the contained iron. Accordingly, the black discoloration of the tarry stool is usually the result of bleeding in the upper digestive tract. However, hematin may also be formed by bleeding in the small or large intestine during very slow digestive processes. If the released hemoglobin stays in the intestine long enough (five hours or more), the bacterial decomposition begins to hematin. The tea chair is often associated with concomitant symptoms such as stinging abdominal pain, nausea and vomiting of blood (hematemesis). However, in the course of blood loss also other health problems such as anemia (anemia) with corresponding oxygen deficiency of the entire organism and headache, tinnitus, fatigue and loss of performance may occur. Also, the tea chair is sometimes accompanied by a prolonged feeling of fullness in gastric cancer in the late stages.
Drug-related or diet-related black or black-brown bowel movements often occur in contrast to the so-called tarry stool without any further symptoms.
Causes of black bowel movements
The black bowel movement in the form of the tarry stool can in principle be caused by any disease that causes bleeding in the (upper) digestive tract. Here are gastric ulcers, gastritis, varicose veins in the esophagus (esophageal varices) and the stomach (gastric varices), esophageal inflammation, chronic inflammatory bowel disease, bacterial intestinal infections or cancers in the gastrointestinal tract to name as possible triggers of bleeding. The bleeding is therefore often the result of serious diseases and urgently need medical care.
Gastric ulcers and gastritis
If the black bowel movement is the result of a gastric ulcer, so-called ulcer bleeding is the cause. These are by no means a rarity as complications in the course of a gastric ulcer and can trigger the vomiting of blood or so-called coffee break vomiting (vomit, which appears to be coffee grounds due to the haematin) in addition to the tarry stool. Since acute bleeding of a gastric ulcer can have life-threatening consequences, they must be breastfed immediately.
The cause may be a duodenal ulcer. (Image: Henrie / fotolia) In gastritis, the tarry stool is the expression of bleeding from the inflamed mucosa. These usually appear only in an advanced stage of gastritis and require urgent medical treatment. In the case of gastritis, the tarry stool is often accompanied by abdominal pain, but also behind the sternum, which are sometimes confused with heartache. In rare cases, inflammation of the esophagus (esophagitis) also causes bleeding that causes a black discoloration of the stool. Both bleeding from gastritis and blood loss from esophageal inflammation can cause anemia over time.
Varicose veins in the esophagus and stomach
Also bleeding from varicose veins in the esophagus (esophageal varices) sometimes cause the excretion of black stool. The veins in the esophagus are sometimes very thin-walled and can easily tear in the case of a varicose vein, causing severe bleeding. In the worst case, the blood loss is so severe that a life-threatening shock can be the result. Vomiting of blood is also relatively common here. Bleeding of the varicose veins must be treated promptly as a medical emergency. Comparable symptoms such as the bleeding of the esophageal varices are expected in case of tearing of varicose veins in the stomach area.
Bleeding due to intestinal inflammation may also be the cause of the tarry stool if the digestive system is significantly slowed down. The intestinal inflammation is usually caused by infections with bacteria or viruses. But also parasites can cause intestinal bleeding. Gastric cancer is one of the most serious illnesses that cause bleeding in the upper digestive tract and black stools. This is favored by various risk factors, in addition to gastric ulcers and gastritis, especially bacterial infections with Helicobacter pylori, dietary influences (for example, too much nitrate or contaminated drinking water) and hereditary predisposition are mentioned.
Other causes of black stool
Black or black-brown stool does not necessarily indicate bleeding in the digestive tract, but can also be caused by certain foods. However, the appearance of the feces in such cases does not correspond to the already mentioned tarry stool. For example, eating larger amounts of meat, black cherries, blackberries or blueberries also causes a black discoloration of the stool. The same may be observed after the intake of red wine. The use of charcoal tablets, iron supplements or other metal-containing drugs often brings with it a black bowel movement. Both the dietary and most drug-induced dark discoloration of stool is a harmless concomitant. Nonsteroidal anti-inflammatory drugs (NSAIDs), however, can cause gastric bleeding that carries a significant health risk. In this case, however, the stool again shows the typical consistency and color as well as the malodour of the tarry stool.
Stool examinations for diagnosis
To determine the cause of the black bowel movement, in addition to a thorough questioning of the patient after eating in the past few days, the intake of medication and other complaints, offers a stool examination. In the course of a more extensive examination, the stools can be observed over a certain period of time and examined for consistency (solid, liquid), color (reddish brown, greenish brown, black or light stool), smell, quantity and ingredients. However, there is also the possibility of using a stool sample within a relatively short time with the help of the so-called hemoccult test possibly contained blood detected. The test can be done by the doctor, but can also be carried out at home with the appropriate test strips.
If no blood can be detected in the stool, a large part of the more serious diseases can be ruled out from the outset as the cause of black stools. In such cases, certain foods or medications usually trigger the discoloration of the feces. However, if the test is positive, further investigations in the sense of a clear diagnosis are urgently needed. In addition to the stool examination accompanying symptoms can sometimes provide important information in the medical diagnosis. Furthermore, gastroscopy and the removal of tissue samples can reliably diagnose diseases such as gastritis, gastric ulcers and stomach cancer. But special ultrasound examinations, as well as imaging techniques of computer tomography and magnetic resonance therapy are sometimes used in the course of diagnosis. Blood tests can also provide information about possibly existing infections in the intestinal area.
Therapy with black bowel movements
If bleeding in the digestive tract is the reason for the black bowel movement, this urgently requires therapeutic measures. These can often be remedied during gastroscopy with the help of special procedures for bleeding in the stomach, the esophagus or the duodenum (so-called endoscopic haemostasis). However, if hemostasis does not succeed, surgery may be required. Once the bleeding is stopped, immediate treatment of the underlying condition should be made. Different methods of treatment are appropriate according to the different causes of black bowel movements. If, for example, a gastritis has developed in the course of an infection with Helicobacter pylori, conventional medicine usually uses antibiotics. Also, so-called acid inhibitors (antacids) are used more frequently in inflammation of the esophagus as well as in gastric mucosal inflammations, in order to prevent further irritation of the tissue by the gastric acid.
Treatment of causes
In natural medicine, gastritis and oesophageal inflammation are often used with healing earth or base powder as well as with mucous, anti-inflammatory and tannin-rich medicinal plants to protect the mucous membrane. Acupuncture, aromatherapy and nutritional therapies are also more commonly part of naturopathic treatment for gastric ulcers. In the course of therapy, special attention is usually paid to the acid-base balance. Further naturopathic treatment approaches for gastritis or esophagitis are provided by the Schüssler salt therapy and homeopathy. Sometimes, osteopathic measures are also used to mechanically influence the function of the esophagus and the stomach. Naturopathy may have limited treatment options for diseases that may be the cause of bleeding in the digestive tract and black stools. In case of doubt, therefore, conventional therapeutic measures can not be avoided. (Fp)
Picture 1: Michael Ottersbach