Abnormal Stool Colors: When to Seek Medical Advice - Gastroenterology and Hepatology

Q: Abnormal Stool Colors: When to Seek Medical Advice

Hello： The color of stool is related to the food consumed and the condition of the gastrointestinal tract. <br>Foods rich in iron can result in darker stool, while consuming red dragon fruit, cactus, or hibiscus may lead to a reddish stool. <br>Personally, I believe that hot dogs

Abnormal stool color?

Hello Doctor: About a month ago, I noticed that my stool often had blood in it, and I experienced pain in my anus.
However, after applying over-the-counter treatments for hemorrhoids and anal fissures, the bleeding stopped.
Recently, I underwent a fecal occult blood test, and at that time, my stool appeared darker, close to black.
I didn't pay much attention to it because my stool tends to be darker when I am constipated.
Today, during a bowel movement, I noticed that my stool had three different colors: one was close to black, another was a yellowish-brown, and there was a smaller amount that was slightly pink, resembling the color of hot dog meat.
Additionally, there was a drop of blood on it.
I did eat a small piece of hot dog yesterday and drank a whole cup of tomato juice this morning, and I'm unsure if that could be related.
Since the results of the fecal occult blood test have not come back yet, should I consider doing another occult blood test? Thank you for your help, Doctor.

Niming, 20~29 year old female. Ask Date: 2017/09/26

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello: The color of stool is related to the food consumed and the condition of the gastrointestinal tract.
Foods rich in iron can result in darker stool, while consuming red dragon fruit, cactus, or hibiscus may lead to a reddish stool.
Personally, I believe that hot dogs are unlikely to cause red stool, but tomato residue may appear red.
A fecal occult blood test report can be referenced.
If there is frequent blood in the stool, it is advisable to consult a colorectal surgeon or a gastroenterologist.
Wishing you peace and health! Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/09/26

More Info

When it comes to abnormal stool colors, it is essential to understand that changes in stool color can be indicative of various underlying health issues. The presence of blood, changes in color, and other symptoms can be concerning and warrant medical attention. Based on your description, it seems you have experienced a range of symptoms, including rectal bleeding, changes in stool color, and pain. Here’s a breakdown of what you should consider and when to seek medical advice.

Understanding Stool Colors
1. Black Stool: Black or tarry stools can indicate bleeding in the upper gastrointestinal tract, such as from a stomach ulcer or esophageal varices. However, certain foods (like black licorice or iron supplements) and medications (like Pepto-Bismol) can also cause black stools.

2. Brown or Tan Stool: This is typically considered normal. However, if the stool is consistently pale or clay-colored, it could indicate a problem with bile production or flow, possibly due to liver or gallbladder issues.

3. Red or Pink Stool: The presence of red or pink in your stool can indicate bleeding in the lower gastrointestinal tract, such as from hemorrhoids or diverticular disease. It can also be influenced by certain foods, such as beets or red dyes.

Symptoms and When to Seek Help
Given your symptoms of rectal bleeding and the presence of different stool colors, it is crucial to monitor your condition closely. Here are some guidelines on when to seek medical advice:
- Persistent Symptoms: If you continue to see blood in your stool or experience pain, it is essential to consult a healthcare provider. Even if the bleeding has stopped, the underlying cause needs to be evaluated.

- Changes in Stool Color: If you notice a consistent change in stool color, especially if it is black or red, it is advisable to seek medical attention. The combination of black and pinkish stool, along with blood, should not be ignored.

- Associated Symptoms: If you experience additional symptoms such as significant abdominal pain, weight loss, changes in appetite, or fatigue, these could indicate a more serious condition that requires immediate evaluation.

Follow-Up Testing
Regarding your question about whether to repeat the fecal occult blood test (FOBT), it may be prudent to discuss this with your healthcare provider. If you have had recent changes in stool color and the presence of blood, your doctor may recommend additional testing to rule out any serious conditions.

Dietary Considerations
You mentioned consuming hot dogs and tomato juice, which can influence stool color. Foods can indeed affect stool appearance, but they do not typically cause blood in the stool. It is essential to keep a food diary to help identify any correlations between your diet and changes in stool color.

Conclusion
In summary, while some variations in stool color can be benign and related to diet, the combination of blood and changes in color you are experiencing is concerning. It is advisable to consult a healthcare professional for a thorough evaluation, which may include a physical examination, further laboratory tests, and possibly imaging studies to determine the underlying cause of your symptoms. Early intervention can be crucial in addressing any potential health issues effectively.

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It may just be food coloring; if you're concerned, you can first check for immunochemical fecal occult blood.