Changes in Stool Color: When to Worry About Blood - Gastroenterology and Hepatology

Bowel issues

Hello Doctor, on Saturday after using the restroom, I noticed that the water in the toilet was a deep coffee color with a hint of red, resembling coffee with a bit of red.
Could this be a sign of colorectal cancer or other bleeding symptoms? I do not feel any discomfort, but I experienced a bit of orthostatic hypotension after lying down and then standing up.
The day before, I only had a meal from a local burger shop, which included a spicy chicken burger, noodle soup, and chicken leg.
I have not consumed any foods with red coloring on that day or in the previous days, and the appearance of my stool and the toilet paper were both normal.
Sunday and today have been normal, and last week, there were a few days when my stool was quite bulky.
While showering, I checked my rectum and found no blood or unusual odor, just the normal smell of stool.
Three years ago, I had a colonoscopy that showed only irritable bowel syndrome and a small hemorrhoid, with no history of rectal bleeding.
Doctor, could this simply be due to consuming too much protein, leading to a change in stool color, rather than bleeding? Or is it possible that the stool was not fully formed and mixed with bleeding from a gastrointestinal tumor, which is why I did not see any blood on the surface? This is the first time this has occurred, and I would appreciate your advice.
Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2021/10/11

Dr. Chen Shidian reply Gastroenterology and Hepatology

Further observation is possible; if concerned, a stool occult blood test can be performed.

Reply Date: 2021/10/11

More Info

When it comes to changes in stool color, especially when you notice a deep coffee color with a hint of red, it can understandably cause concern. However, based on your description, there are several factors to consider before jumping to conclusions about serious conditions like colorectal cancer.

Firstly, the color of stool can vary significantly based on diet, hydration levels, and gastrointestinal health. Foods high in protein, such as the spicy chicken burger you mentioned, can sometimes lead to darker stools. Additionally, if you consumed any foods that might have contained dark pigments or dyes, this could also affect the color. It’s worth noting that certain medications and supplements can also alter stool color.

You mentioned that your stool appeared normal in subsequent days and that you did not experience any discomfort or other symptoms, which is a positive sign. The absence of blood in your stool, as well as the normal appearance of your bowel movements and the lack of any unusual odor, further suggests that there may not be a serious underlying issue.

Regarding your concern about potential bleeding, it’s important to understand that if there were significant bleeding in the gastrointestinal tract, you would likely notice other symptoms, such as abdominal pain, changes in bowel habits, or the presence of blood in the stool itself. The fact that you have a history of irritable bowel syndrome (IBS) and mild hemorrhoids could also explain occasional changes in bowel habits or stool appearance without indicating a more serious condition.

However, it’s crucial to remain vigilant. If you notice persistent changes in stool color, especially if accompanied by other symptoms such as abdominal pain, weight loss, or changes in appetite, it would be wise to consult a healthcare professional. They may recommend further evaluation, such as a repeat colonoscopy, especially given your previous history and the fact that this is the first time you’ve noticed such a change.

In summary, while your recent experience with stool color changes could be attributed to dietary factors or temporary gastrointestinal fluctuations, it’s always best to err on the side of caution. Monitoring your symptoms and maintaining open communication with your healthcare provider will ensure that any potential issues are addressed promptly. If the color change recurs or if you develop any new symptoms, do not hesitate to seek medical advice. Your health and peace of mind are paramount.

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