Green Stool: Causes and When to Seek Medical Advice

Noticing green stools?

Hello Doctor, I have been taking antibiotics for a week due to Helicobacter pylori, and during that time my bowel movements were normal.
However, yesterday morning my stool turned deep green and had a formed appearance.
I noticed food remnants when wiping.
This morning, my stool started off similarly to yesterday, with a slightly green color, but later became unformed and darker green.
Should I be concerned about gastrointestinal bleeding? Recently, I underwent an endoscopy and was diagnosed with a gastric ulcer, and I am experiencing significant bloating and tightness in my back.
Should I seek further evaluation?

CHY, 30~39 year old female. Ask Date: 2024/04/17

Dr. Luo Yining reply Gastroenterology and Hepatology

There are several factors that can cause green stools, such as consuming excessive amounts of dark green vegetables, side effects from certain medications like iron supplements, intestinal infections, indigestion, or diarrhea that prevents bile from being properly broken down.
Gastrointestinal bleeding from a gastric ulcer typically results in tarry, black, and sticky stools, while significant bleeding may present as dark red or bright red blood in the stool.
If the stool color continues to change or if there are changes in bowel habits, it is advisable to consult a gastroenterologist for evaluation and possible further testing.

Reply Date: 2024/04/17

More Info

Green stool can be a concerning symptom, especially when accompanied by other gastrointestinal issues. In your case, the recent use of antibiotics for Helicobacter pylori infection, along with your history of gastric ulcers and gastrointestinal discomfort, raises some important considerations.

Firstly, the color of stool can be influenced by several factors, including diet, medications, and underlying health conditions. Green stool is often a result of bile pigment passing through the intestines too quickly, which can happen due to various reasons such as diarrhea, certain foods (like leafy greens or foods with green dye), or the use of specific medications. In your situation, antibiotics can alter gut flora, potentially leading to changes in stool consistency and color.

The presence of food remnants in your stool may indicate that your digestive system is not fully breaking down food, which can happen if there is a gastrointestinal disturbance. This could be related to your gastric ulcer and the associated symptoms of bloating and back tightness. The fact that your stool has changed from formed to unformed could suggest a shift in your digestive process, possibly due to irritation or inflammation in your gastrointestinal tract.

Regarding your concern about gastrointestinal bleeding, dark green stool is not typically a direct indicator of bleeding. However, if you notice any blood in your stool, black tarry stools, or experience significant abdominal pain, it is crucial to seek medical attention immediately. These could be signs of more serious conditions, including bleeding ulcers or other gastrointestinal issues.

Given your history of gastric ulcers and the current symptoms you are experiencing, it would be prudent to consult with your healthcare provider for further evaluation. They may recommend additional tests, such as stool tests, imaging studies, or even a repeat endoscopy, to assess the state of your gastrointestinal tract and rule out any complications related to your ulcer or other conditions.

In summary, while green stool can be benign and related to dietary changes or medications, your ongoing symptoms of bloating, back tightness, and changes in stool consistency warrant further investigation. It is essential to communicate all your symptoms to your healthcare provider, who can guide you on the appropriate next steps for diagnosis and treatment. Remember, proactive management of your gastrointestinal health is crucial, especially with your history of ulcers and current treatment for H. pylori.

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