Black Stool: When to Seek Medical Attention

After having a bowel movement, the water appears to be a dark color?

Today I had three bowel movements.
The first two were loose stools, but the third one really scared me.
When I got up and looked in the toilet, the water was completely black, and there were dark green stools in it.
Upon closer inspection, I noticed there were red streaks on the dark green stools.
Two days ago, I had a dull pain in my lower right abdomen; it wasn't very painful, but it lasted quite a while.
However, on September 4th, I had a follow-up colonoscopy, and the doctor said everything was fine.
I also had a colonoscopy and gastroscopy on August 8th.
Should I go for another consultation? Doctor, I'm really very anxious.

Jiao lü de ren, 20~29 year old female. Ask Date: 2013/09/14

Dr. Ke Fangxu reply Surgery

If you have already undergone both gastroscopy and colonoscopy, there is likely not much to worry about.
Abnormal stool patterns are often related to diet; if you have consumed darker or more irritating foods in the past few days, this could reflect in your stool.
Additionally, since you are only 20 years old, the likelihood of developing serious illnesses is generally low.
Therefore, I would not recommend any further examinations.
I suggest adopting a healthy lifestyle and monitoring your condition closely.

Reply Date: 2013/09/14

More Info

Black stool can be a concerning symptom, and it's understandable that you're feeling anxious about it. The appearance of black stool, especially when accompanied by red streaks, can indicate several potential issues, some of which may require medical attention.

Firstly, black stool often suggests the presence of digested blood, which can result from bleeding in the upper gastrointestinal tract. Conditions such as peptic ulcers, gastritis, or esophageal varices can lead to this type of bleeding. The red streaks you mentioned could indicate fresh blood, which might suggest bleeding from a lower gastrointestinal source, such as hemorrhoids or anal fissures, especially if you have been experiencing discomfort in your lower abdomen.

Given your recent medical history, including a colonoscopy and endoscopy, it's important to consider that while these procedures can rule out many serious conditions, they do not eliminate the possibility of new issues arising. The fact that you experienced right lower abdominal discomfort prior to noticing the changes in your stool could be significant. This discomfort, combined with the changes in your bowel movements, warrants further investigation.

Here are some steps you should consider:
1. Seek Medical Attention: Given the changes in your stool color and the presence of red streaks, it is advisable to consult a healthcare professional. Even though you had recent endoscopic evaluations, new symptoms can arise, and it’s crucial to have a thorough assessment.

2. Describe Your Symptoms: When you see a doctor, be sure to provide a detailed account of your symptoms, including the duration of the black stool, any associated pain, and the specifics of your abdominal discomfort. This information will help your doctor determine the appropriate next steps.

3. Potential Tests: Your doctor may recommend further testing, such as a repeat colonoscopy, imaging studies (like a CT scan), or laboratory tests to check for anemia or other signs of bleeding.
4. Monitor Your Symptoms: Keep track of any additional symptoms that may develop, such as changes in appetite, weight loss, or increased pain. This information can be vital for your healthcare provider.

5. Avoid Self-Diagnosis: While it’s easy to turn to the internet for answers, self-diagnosing can lead to unnecessary anxiety. Trust your healthcare provider to guide you through the diagnostic process.

In summary, while your previous colonoscopy and endoscopy were normal, the appearance of black stool and associated symptoms should not be ignored. It’s essential to seek medical advice promptly to rule out any serious conditions and to receive appropriate care. Your health is paramount, and addressing these symptoms with a healthcare professional is the best course of action.

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I'm sorry, but I can't assist with that.

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