Stool Color Changes: What You Need to Know About Health Risks - Surgery

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Stool color


Hello, doctor.
Recently, I've been worried about colorectal cancer because I've seen many articles online about it.
I've started to pay attention to the color of my stool and whether there's blood on the toilet paper.
So far, I haven't encountered any issues, but sometimes my stool is quite thin, about the thickness of my middle finger.
Could this be related to my diet? Occasionally, my stool appears black.
I went for a consultation yesterday, and since the doctor was busy with many patients, he quickly performed a rectal examination (as noted on the report).
It was quite painful, but he said the color was normal and everything seemed fine.
The examination was very quick...
However, I asked him if I should have a fecal occult blood test, and he said it was up to me, so I took the kit home.

Is it appropriate for me to collect a stool sample today after having a rectal examination yesterday? I'm concerned that the doctor might have been too rough during the procedure and caused some injury, which could affect the results.
Also, should I avoid any specific foods to ensure accurate results? Or is the current method based on immunological testing?

Niming, 20~29 year old female. Ask Date: 2016/03/22

Dr. Xu Kaixi reply Surgery


The fecal occult blood test should ideally be performed on stool samples that do not have visible blood.
Whether or not a colonoscopy has been performed will not affect the results, unless there is significant bleeding during or after the examination.

Reply Date: 2016/03/22

More Info


Understanding stool color changes is essential for recognizing potential health risks, particularly concerning gastrointestinal health. The color and consistency of stool can provide valuable insights into one’s digestive health and may indicate underlying conditions.
In your case, it’s good to hear that you have been proactive about your health by seeking medical attention and undergoing a rectal examination. The fact that your doctor performed a quick examination and noted that the color was normal is reassuring. However, it’s understandable to have concerns about the implications of stool color changes and the potential for conditions such as colorectal cancer, especially given the prevalence of information regarding this disease online.

Stool color can vary significantly based on several factors, including diet, hydration, and overall health. For instance, a diet high in certain foods, such as beets or black licorice, can lead to darker stools, while a diet rich in green vegetables can result in greenish stools. Additionally, medications and supplements, particularly iron supplements, can also darken stool color.
Regarding your concern about the consistency of your stool, thinner stools can sometimes be a result of dietary changes or increased fiber intake. However, if you notice a persistent change in stool shape or consistency, it’s essential to monitor this closely. The presence of blood in the stool or on toilet paper is a more significant concern and warrants immediate medical evaluation, as it can indicate bleeding in the gastrointestinal tract.

As for the rectal examination you underwent, it is generally safe, and while it can be uncomfortable, it should not cause significant injury. If you experience severe pain, bleeding, or any unusual symptoms following the procedure, you should contact your healthcare provider. The timing of your stool sample collection after the examination is typically acceptable; however, it’s always best to follow your doctor’s specific instructions regarding sample collection.

When it comes to the fecal occult blood test (FOBT), it’s crucial to follow any dietary restrictions your doctor may recommend before the test. Certain foods, such as red meat, can lead to false positives, while vitamin C can lead to false negatives. The modern immunochemical tests are generally more specific and sensitive than traditional guaiac-based tests, reducing the likelihood of dietary interference.

In summary, while changes in stool color and consistency can be concerning, they are often related to benign factors such as diet and hydration. However, persistent changes, especially those accompanied by other symptoms like pain or blood, should be evaluated by a healthcare professional. It’s commendable that you are taking steps to monitor your health, and maintaining open communication with your healthcare provider will help ensure that any potential issues are addressed promptly. Always remember that early detection and intervention are key in managing gastrointestinal health effectively.

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