Abdominal Pain and Black Stool: When to See a Gastroenterologist?

Q: Abdominal Pain and Black Stool: When to See a Gastroenterologist?

Hello： It is recommended to consult both a gastroenterologist and an obstetrician-gynecologist, as they may influence each other. <br>Alternatively, you may first see a gastroenterologist, and if there is no improvement, then consult an obstetrician-gynecologist. <br>Changhua Hos

I have unusual discomfort in my lower abdomen, and it hurts when I press on it. My stool is black?

Hello Doctor, three days ago I started feeling a dull ache in my lower abdomen, similar to the sensation of needing to have a bowel movement, but I can't seem to go.
Even when I do manage to pass something, the amount is very small (sometimes just a tiny pellet).
The stool is black in color, and I only feel some pain when I press on the area; otherwise, it just feels uncomfortable and strange.
I initially thought it was just a constipation issue, but even after having a successful bowel movement, my abdomen still feels uncomfortable, and there is pain when I press on it.
Since this has been going on for three days, should I see a gynecologist or a gastroenterologist first? Thank you, Doctor.

QQ, 20~29 year old female. Ask Date: 2016/08/19

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: It is recommended to consult both a gastroenterologist and an obstetrician-gynecologist, as they may influence each other.
Alternatively, you may first see a gastroenterologist, and if there is no improvement, then consult an obstetrician-gynecologist.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/08/19

More Info

When experiencing abdominal pain accompanied by black stool, it is crucial to seek medical attention promptly, particularly from a gastroenterologist. The symptoms you describe—persistent lower abdominal discomfort, difficulty in bowel movements, and the presence of black stool—can indicate several underlying issues that require further investigation.

Black stool, also known as melena, can be a sign of gastrointestinal bleeding, typically originating from the upper gastrointestinal tract, such as the stomach or duodenum. Common causes of melena include peptic ulcers, gastritis, esophageal varices, or even malignancies. The fact that you are experiencing abdominal pain along with these symptoms raises the concern for potential gastrointestinal pathology that should not be overlooked.

Given that you have been experiencing these symptoms for three days, it is advisable to consult a gastroenterologist rather than a gynecologist. Gastroenterologists specialize in diagnosing and treating conditions related to the digestive system, including the stomach, intestines, and colon. They can perform necessary diagnostic tests, such as stool tests, endoscopy, or imaging studies, to determine the cause of your symptoms.

In addition to the black stool, the sensation of pressure or discomfort in the abdomen, especially if it is localized and associated with pain upon palpation, could suggest conditions such as constipation, bowel obstruction, or even inflammatory bowel disease. While constipation can lead to discomfort and changes in stool consistency, the presence of black stool is particularly concerning and warrants further evaluation.

It is also important to consider your overall health history, including any medications you may be taking, dietary habits, and any other symptoms you might be experiencing, such as nausea, vomiting, or weight loss. Certain medications, especially nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants, can increase the risk of gastrointestinal bleeding. Additionally, dietary factors, such as the consumption of iron supplements or foods that can darken stool, should be taken into account.

In summary, based on your symptoms of abdominal pain and black stool, it is strongly recommended that you schedule an appointment with a gastroenterologist. They will be able to conduct a thorough evaluation, including a physical examination and necessary diagnostic tests, to identify the underlying cause of your symptoms. Early intervention is key in managing any potential gastrointestinal issues effectively, so do not hesitate to seek medical care. Your health and well-being are paramount, and addressing these symptoms promptly can lead to better outcomes.

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