The black diarrhea

introduction

The discoloration of diarrhea can vary in appearance and result from a variety of causes. The discoloration is often caused by diet, i.e. the intake of certain foods or nutritional supplements.

In addition, bleeding from the stomach or small intestine mucous membrane can turn the stool black and cause diarrhea. Therefore, long-lasting and recurring symptoms with black diarrhea should be clarified.

The causes of black diarrhea

• Overdose of iron tablets

• The consumption of ferrous foods (spinach ...)

• The consumption of dark colored foods (red wine, beetroot ...)

• The bleeding on the mucous membrane of the upper gastrointestinal tract:

  • esophagus
  • stomach
  • Duodenum

• Eating dark food coloring

• Endometriosis (e.g. tissue of the uterine lining in the intestine, which builds up and degrades with the monthly cycle)

Food coloring as the cause

The molecular components of food coloring are mostly not used by the body and are excreted. Therefore, excessive consumption of food coloring can also cause black diarrhea. Particularly dark and undiluted dyes are suitable for this.

If the black diarrhea cannot be clearly attributed to the consumption of food coloring, other causes such as bleeding should definitely be ruled out. The same applies if the diarrhea persists for a few days after consuming food coloring.

Taking iron tablets

Excess iron is excreted from the body through the gastrointestinal tract. So if you take iron tablets in too high a dose, or if the iron from the preparations cannot be easily absorbed through the intestines, you will, so to speak, “get rid of” the iron with the stool. The diarrhea is then black - which makes it difficult to distinguish from blood.

So if the intake of iron tablets could be a possible cause of the black diarrhea, you should consider stopping the preparation or using a lower dose.

Taking antibiotics

Antibiotic drugs can in fact cause diarrhea: This is due to the fact that when taken orally they can attack the natural bacterial flora of the intestinal mucosa. The bacterial residue that is then excreted in the stool can discolour the diarrhea, but the color is rarely black.

Completely black diarrhea is most commonly caused by bleeding in the upper gastrointestinal tract, which antibiotics usually do not cause. However, if the diarrhea persists after taking the antibiotics, medical advice should be sought.

This article might also interest you: The side effects of atibiotics.

Consumption of red wine

Dark coloring agents ingested with food can also cause discoloration of the stool. Such foods include red wine, to which additional colorings are sometimes added to make the color appear more intense.

It should therefore be ensured that red wine was consumed before the occurrence of black diarrhea, as this could be the trigger.

The gastrointestinal bleeding as the cause

Black diarrhea can be caused by bleeding in the lining of the gastrointestinal tract. The localization of the bleeding is very likely to be found in the upper part of the gastrointestinal tract, because the blood coagulates on its way through the gastrointestinal tract and the iron it contains causes the stool to turn black and change the consistency of the stool . Because of these two factors, one speaks of a tarry stool.

The diagnosis usually involves a reflection of the stomach and upper duodenum.

Find out all about the topic here: The gastrointestinal bleeding.

The use of the pill as the cause

The birth control pill intervenes in the female hormonal cycle to prevent pregnancy. Depending on the preparation and the hormone it contains, ovulation or the build-up of the uterine lining is inhibited. However, the hormonal balance also affects other organs of the body, including the gastrointestinal tract. It is therefore possible that existing irritable bowel syndrome - that is, recurrent diarrhea and constipation - is made worse by taking the pill.

However, these diarrhea is usually not black. If the color of the diarrhea differs from the other color of the stool, other causes should be looked for.

Further information on this topic can be found at: The diarrhea from the pill.

Taking pain medication

Certain painkillers can also be the cause of black diarrhea: The so-called non-steroidal anti-inflammatory drugs, which include diclofenac and Aspirin®, can damage the stomach lining and cause bleeding, which turns stool black, i.e. tarry stools. This happens via the inhibition of a certain enzyme, which is responsible for building up the protective layer of mucus in the stomach.

Without this functioning protective layer, the aggressive stomach acid can reach the surface of the mucous membrane and damage the tissue. For this reason, if such drugs are taken on a long-term and regular basis, a proton pump inhibitor, such as omeprazole or pantoprazole, should also be given. These ensure a less aggressive stomach acid, which makes the mucosal defects less dangerous.

The accompanying symptoms

In principle, a distinction should be made between two causes of black discoloration: On the one hand, the discoloration can result from the excretion of a large amount of dye or iron that accumulates in the body through food consumed. These substances are not absorbed in the intestine and therefore attract more water molecules into the intestine in order to balance the concentration on both sides of the intestinal mucosa. So more fluid is added to the volume of the stool and black diarrhea develops.
This type of black diarrhea is certainly annoying, but not pathological and does not necessarily have to be treated. As with all types of diarrhea, you should ensure that you drink enough fluids. If necessary, stool thickening drugs such as loperamide can also be taken.

Another major cause that typically leads to black diarrhea is bleeding in the upper gastrointestinal tract. This could also be just a little bleeding from which only a small amount of blood oozes out. This blood coagulates on its way through the intestines and turns the stool dark. The clotted blood also draws more water into the intestines, making the stool consistency soft or mushy. If the symptoms persist for a long time, this cause of black diarrhea should definitely be clarified and ruled out. A longer period is given for complaints of over one to two weeks, without the complaints being due to food supplements or dyes.

The flatulence as a symptom

Due to the change in stool consistency that causes diarrhea, flatulence is also a typical syndrome accompanying these complaints. Basically, these are the gases that are given off by the bacteria naturally present in the colon when they utilize the remaining nutrients from the stool.

However, flatulence occurs in some people even in a healthy state - it is therefore a very unspecific symptom without any disease value. So whether or not flatulence occurs with black diarrhea is less important than other accompanying symptoms and the time course of the symptoms.

The abdominal pain as a symptom

Abdominal pain is a symptom that often accompanies diarrhea. The pain can be perceived as deep and pressing or cramping, or it can feel more like a discomfort. Since the intestine is innervated by many nerve cells, abdominal pain is a typical symptom. The pain doesn't have to be an immediate cause for concern. However, if the time course increases over a longer period of days, a doctor should definitely be consulted.

Read more about the topic here: The stomach ache.

Constipation as a symptom

It can happen that constipation and diarrhea alternate. This can be an indication of what is known as irritable bowel syndrome: a common disease that usually causes symptoms for many years. Women suffer from this condition more often than men. Possibly this is due to a hormonal influence that makes irritable bowel syndrome worse.

In irritable bowel syndrome, however, a black stool is atypical. The feeling of constipation, paired with diarrhea, can also indicate a mass in the colon. However, tumors in the large intestine usually do not cause stools to turn black. If these symptoms occur together, a more detailed analysis of the causes is necessary.

You can find more information on the topic here: The constipation.

The diagnosis

Persistent black diarrhea should be clarified in any case, as bleeding and an associated defect in the gastrointestinal mucosa may be the cause. This bleeding is to be suspected in the upper part of the gastrointestinal tract, as the leaked blood only has enough time to clot before it is excreted. This distinguishes bleeding from the upper gastrointestinal tract from that of the lower, as the latter is more likely to have a red, bloody coloration of the stool. Diagnostics will therefore usually include a reflection of this area, specifically of the esophagus, the stomach and the adjoining duodenum. All of this can be done together, so there is no need for multiple reflections.

In addition, a detailed survey should be carried out on the foods consumed, especially those that can trigger black diarrhea, as well as the use of dietary supplements and medication.

Blood in the stool? Find out more about this topic here.

Which black diarrhea needs treatment?

Diarrhea can have a wide variety of causes, regardless of color, and not all of them require treatment. In principle, diarrhea should be treated if it lasts longer than three days or if other serious symptoms are caused by the loss of fluid and electrolytes. Such symptoms can include dizziness and circulatory problems.

A black coloration of the stool or diarrhea does not necessarily require treatment if this is only noticed occasionally.However, if the black color remains unchanged over several weeks, further diagnostics and appropriate therapy should be initiated.

Can that be an indication of cancer?

Black diarrhea can be caused by blood in the stool. For example, the blood may indicate bleeding from the lining of the gastrointestinal tract. Such bleeding can be caused by a tumor.

Different types of tumor growth can be distinguished, and not all types cause bleeding. However, there are tumors that cause mucosal defects in the intestine, from which blood can then leak. In any case, if black diarrhea recurs, further diagnostics should also be carried out to exclude a tumor.

Read more about the topic here: Colon cancer.

The duration and forecast

The duration and prognosis of black diarrhea depend on the cause. Discomfort caused by food or dietary supplements will subside two to three days after the excess substance has been excreted through the body.

On the other hand, symptoms that last for weeks or months indicate a source of bleeding in the body. These can be small wounds in the upper gastrointestinal tract, and endometriosis can also be considered in women. Endometriosis refers to dispersed tissue of the uterine lining, which can be located in the intestine, for example, and builds up and breaks down according to the hormonal cycle.

The duration of the black diarrhea also gives the person concerned an indication of how in need of treatment the symptoms are. The following rule of thumb applies: if the symptoms last for one to two weeks at the latest, a doctor should be consulted.

The black diarrhea in the baby

Babies have a shorter intestinal passage and less stool volume, so the amount of dye ingested with food is more significant. This means that discoloration of the stool can occur more quickly. It should also be noted that babies naturally have more bowel movements and the definition of diarrhea is therefore different from that of older children and adults: Babies only speak of diarrhea from five liquid stools.

Black coloring in diarrhea can always be caused by bleeding in the gastrointestinal tract. If the baby has black diarrhea for the first time or for no apparent reason, medical advice should still be sought.

This article might also interest you: Diarrhea in the baby.

The black diarrhea in the child

In children - similar to babies - the intestinal passage is even shorter than in adults. Accordingly, children's bodies react faster to an overload with dyes or nutritional supplements such as iron tablets. Black diarrhea in children is therefore not fundamentally pathological or in need of therapy.

However, as with such complaints at any age, medical advice should be sought and bleeding in the gastrointestinal tract should be excluded if the child has black diarrhea. This is especially true if these symptoms persist for more than several days to a whole week.

Also read the article: The diarrhea in the toddler.