Dark Stool: Should You Worry About Colon Cancer?

Bowel issues

Hello Doctor, two Saturdays ago after using the restroom, I noticed that the water in the toilet had a dark coffee color, and it seemed slightly red, resembling coffee with a hint of red.
Could this be a sign of colon cancer or other bleeding symptoms? I do not feel any discomfort, but I have experienced some orthostatic hypotension after lying down and then standing up.
The Friday before that, I only had a Dan Dan burger meal, which included a spicy chicken thigh burger, noodle soup, and chicken leg.
I did not consume any foods with red coloring on that day or in the days prior, and the appearance of my stool and toilet paper was normal.
Since that Sunday until today, everything has appeared normal, sometimes with a darker coffee color, and the toilet water has only shown some coffee-yellow color.
There were a few days last week when my stool was quite bulky, and over the past two weeks, I have occasionally experienced diarrhea or had less frequent and less bulky stools, going to the bathroom about twice a day.
During a shower, I checked my rectum and found no blood or unusual odor, just the normal smell of stool.
Three years ago, I had a colonoscopy, which only showed irritable bowel syndrome and a slight hemorrhoid, with no history of rectal bleeding.
Doctor, could this possibly not be bleeding? Or could it be that unformed stool mixed with gastrointestinal tumor bleeding, hence not visible on the surface? Today, I consulted a traditional Chinese medicine doctor, who suggested that dietary factors are more likely the cause, while the Western doctor advised me to monitor the situation.
Since I had a colonoscopy only three years ago, it should not be a problem, as a colonoscopy can be effective for 5-10 years.
Currently, the only family member who passed away from cancer is my grandfather's second brother, and I am unsure if it was due to colon cancer.
If he did die from colon cancer, should I be concerned, considering he is from my grandfather's generation? In my generation, my father's generation, and my grandfather's generation, there have been no other reported cases of cancer, and my mother's family has none either.
This is the first time I have experienced this, so I would appreciate your advice.
Thank you, Doctor.

wei, 20~29 year old female. Ask Date: 2021/10/22

Dr. Hong Yuanbin reply Internal Medicine

Hello, the chili powder in the spicy chicken leg burger may cause a deep red discoloration, but it's not just the chili powder; many foods, especially vegetables and fruits, can contain food coloring.
Therefore, it may not necessarily indicate bleeding.
However, since your family member has a history of colorectal cancer, you are indeed in a high-risk group.
It is advisable for you to undergo a fecal occult blood test.
If the results are normal, you can feel reassured.
If the results are abnormal, it is still recommended to have a colonoscopy for further examination.
Thank you for your question.

Reply Date: 2021/10/22

More Info

When it comes to the concern of dark stool and its potential implications for colon cancer, it is essential to approach the situation with a comprehensive understanding of gastrointestinal health and the various factors that can influence stool appearance.

Firstly, the observation of dark brown or coffee-colored water in the toilet after a bowel movement can be alarming, especially when accompanied by any hint of red. However, it is crucial to note that stool color can vary significantly based on diet, hydration levels, and other physiological factors. In your case, you mentioned consuming a spicy chicken burger and other foods, which could contribute to changes in stool color. Additionally, the absence of any discomfort, blood in the stool, or other alarming symptoms is a positive sign.

The fact that your stool has returned to a normal appearance and that you have not experienced any significant changes in bowel habits or discomfort suggests that this may not be a serious issue. It is also worth noting that you have a history of irritable bowel syndrome (IBS) and mild hemorrhoids, which can sometimes lead to changes in bowel habits and stool appearance without indicating a more severe underlying condition.

Regarding your concerns about colon cancer, it is important to consider your previous colonoscopy, which was performed three years ago and showed no significant issues aside from IBS and mild hemorrhoids. Colonoscopies are generally recommended every 5 to 10 years for individuals at average risk, and since you are relatively young and have no significant family history of colorectal cancer (aside from your great-uncle), your risk remains low.

However, it is always wise to be vigilant about any changes in your body. If you notice persistent changes in stool color, especially if accompanied by symptoms such as abdominal pain, significant changes in bowel habits, weight loss, or blood in the stool, it would be prudent to consult a healthcare professional for further evaluation.
In terms of your family history, while having a relative with cancer can increase your awareness and concern, it is essential to consider the specifics of that case. If your great-uncle had colon cancer, it may warrant a discussion with your doctor about whether you should begin screening earlier than the standard recommendations, especially if there are other risk factors present.

In summary, while the dark stool you observed could be concerning, it is likely related to dietary factors or temporary changes in your gastrointestinal function. Given your previous colonoscopy results and the absence of alarming symptoms, it is reasonable to monitor your condition and maintain a healthy lifestyle. If symptoms persist or worsen, seeking medical advice would be the best course of action. Always trust your instincts about your health and do not hesitate to reach out to a healthcare provider for peace of mind.

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