Intermittent Black Stool: Causes and Concerns for Young Patients

Intermittent black stools?

Hello Doctor, about six months ago, I started experiencing intermittent black stools, and sometimes I would have abdominal pain at night, which made me quite concerned.
Later, my parents took me for an abdominal ultrasound due to my persistent worries, and fortunately, there were no issues found.
However, my grandfather was diagnosed with stomach cancer, and hearing about the symptoms and the fact that the endoscopy was inconclusive made me worry that he might have the notorious diffuse gastric cancer.
This made me anxious, but my grandfather is 60 years old, which is quite different from my age of 13! Still, I am very scared that this could be hereditary.
I’ve heard that young people who get stomach cancer often have diffuse gastric cancer.
Doctor, besides stomach cancer, what other diseases could I potentially have? What do you recommend I do now? P.S.
My blood test results from last semester were all normal.

Li Tongxue, 10~19 year old female. Ask Date: 2023/06/18

Dr. Chen Shidian reply Gastroenterology and Hepatology

If the fecal occult blood test is positive, then proceed with endoscopic examination.

Reply Date: 2023/06/18

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding intermittent black stool and the anxiety surrounding your family history of gastric cancer. It’s understandable to feel worried, especially given the recent diagnosis of your grandfather. However, it’s important to approach this situation with a clear understanding of potential causes and the steps you can take to address your health concerns.

Firstly, black stool can be indicative of several conditions, and it’s crucial to differentiate between them. The most common cause of black stool is the presence of digested blood, which can result from bleeding in the upper gastrointestinal tract, such as from ulcers, gastritis, or esophageal varices. However, there are other non-pathological reasons for black stool, such as the consumption of certain foods (like black licorice, blueberries, or beets) or medications (like iron supplements or bismuth subsalicylate, commonly found in Pepto-Bismol).

Given that you have undergone an abdominal ultrasound and no issues were found, this is a positive sign. However, if the black stool persists or is accompanied by other symptoms such as abdominal pain, vomiting, or changes in appetite, it would be prudent to follow up with a healthcare provider. A gastroenterologist may recommend further evaluation, such as an endoscopy, to rule out any underlying conditions that may not have been visible on the ultrasound.

Regarding your concerns about hereditary gastric cancer, it’s important to note that while some types of gastric cancer can have a genetic component, the risk is generally lower in younger individuals. The most common form of gastric cancer, adenocarcinoma, is more prevalent in older adults. The diffuse type of gastric cancer, which is what you mentioned, can occur in younger patients but is still relatively rare. Your age and the absence of other risk factors (such as a family history of gastric cancer in first-degree relatives) suggest that your risk is likely low.

To address your anxiety, consider the following steps:
1. Consult a Healthcare Professional: If you continue to experience black stool or abdominal pain, it’s essential to consult a healthcare provider for further evaluation. They can provide reassurance and guide you through any necessary tests.

2. Monitor Your Symptoms: Keep a diary of your symptoms, noting when they occur, their frequency, and any associated factors (like diet or stress). This information can be helpful for your healthcare provider.

3. Educate Yourself: Understanding your health can alleviate anxiety. Research reputable sources about gastrointestinal health and common conditions that could cause your symptoms.

4. Talk About Your Fears: Share your concerns with a trusted adult, such as a parent or teacher. They can provide support and help you navigate your feelings.

5. Practice Stress-Relief Techniques: Engage in activities that help reduce anxiety, such as exercise, meditation, or hobbies you enjoy. This can help you manage your worries about health.

6. Regular Check-Ups: Since you mentioned that your blood tests were normal, continue with regular health check-ups to monitor your overall health. This can provide peace of mind.

In summary, while your symptoms warrant attention, the likelihood of serious conditions, especially at your age, is relatively low. Focus on maintaining a healthy lifestyle, staying informed, and seeking medical advice when necessary. Remember, it’s always better to address health concerns proactively rather than letting anxiety take over.

Take care, and I wish you the best in your health journey.

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