Black Stool After Endoscopy: When to Seek Medical Attention

Black stools after gastric biopsy?

Hello, doctor.
I recently underwent an endoscopy, and no ulcers or abnormalities were found.
However, a biopsy for Helicobacter pylori was performed, and the doctor explained that the biopsy site would heal in about two to three days.
The next day, I noticed black stools and experienced mild discomfort in my stomach.
Should I expect this to improve on its own, or do I need to seek further medical attention? Thank you, doctor.

Niming, 20~29 year old female. Ask Date: 2020/03/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

Gastric biopsy should not cause black stools; if black stools are present, it indicates gastrointestinal bleeding, and further examinations such as small bowel endoscopy or colonoscopy should be conducted.

Reply Date: 2020/03/11

More Info

Black stool, or melena, can be a concerning symptom, especially following an endoscopic procedure like an upper gastrointestinal (GI) endoscopy. The presence of black stool typically indicates that there is bleeding in the upper GI tract, which can be due to various reasons, including ulcers, gastritis, or even the effects of medications. However, in your case, since the endoscopy did not reveal any ulcers or significant abnormalities, it is essential to consider a few factors.

After an endoscopy, especially if biopsies were taken, it is not uncommon for patients to experience some mild discomfort or changes in bowel habits. The black stool you are experiencing could be related to the procedure itself, particularly if there was any minor bleeding from the biopsy sites. The fact that your doctor mentioned that the biopsy sites would heal in a few days suggests that this could be a transient issue. However, it is crucial to monitor the situation closely.

Here are some key points to consider regarding your symptoms:
1. Timing and Nature of Black Stool: If the black stool persists for more than a couple of days or is accompanied by other symptoms such as significant abdominal pain, dizziness, or weakness, it is essential to seek medical attention promptly. Persistent black stool could indicate ongoing bleeding that may require further evaluation.

2. Associated Symptoms: You mentioned experiencing mild discomfort in your stomach. If this discomfort worsens or if you develop additional symptoms such as vomiting blood, feeling faint, or having a rapid heartbeat, these could be signs of a more serious condition, and you should seek immediate medical care.

3. Self-Resolution: In some cases, if the black stool is indeed related to minor bleeding from the biopsy sites, it may resolve on its own as the tissue heals. However, it is essential to ensure that this is the case and not a sign of a more significant issue.

4. Follow-Up: Since you had a procedure done, it is advisable to follow up with your healthcare provider, especially if the black stool does not resolve within a few days. They may recommend further testing, such as a repeat endoscopy or imaging studies, to rule out any complications.

5. Diet and Medications: Consider any medications you might be taking, including over-the-counter medications like iron supplements or bismuth subsalicylate (Pepto-Bismol), which can also cause black stools. If you are taking any new medications, discuss these with your doctor.

In summary, while it is possible that your black stool may resolve on its own, it is crucial to monitor your symptoms closely. If you experience any worsening of your condition or if the black stool persists, do not hesitate to contact your healthcare provider for further evaluation. Your health and safety are paramount, and it is always better to err on the side of caution when it comes to potential gastrointestinal bleeding.

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