While we no longer live in the Victorian age, full of inflexible morals and strict manners, there are still some things that we often find it hard to talk about. This especially includes medical issues. To most people, while we are now more generally educated about medical matters than ever, speaking about sensitive medical issues can be embarrassing or even almost impossible. One subject people find it hard to discuss – even with their doctors – is their bathroom habits, and that includes their stool.
Unfortunately, problems with stool – anything from diarrhea, to constipation, to a suspicious change in the color, shape or consistency of the stool. For example, black stools can be caused by a very serious condition having to do with the gastrointestinal system.
Black stools caused by gastrointestinal problems are known by the scientific name of melena or melaena. These black stools are often dark and tarry in consistency, which is caused by the process of oxidation occurring within the iron in the stool as it passes through the ileum and colon. Unfortunately, this black stool is often caused by a very serious problem – gastrointestinal hemorrhaging or perhaps a peptic ulcer.
When black stools occur, they are generally caused by bleeding in the upper or lower gastrointestinal (GI) tract. Parts of the lower GI tract include the sigmoid colon and the rectum. When the bleeding occurs within the GI tract, the blood is generally bright red as one would expect. When blood is present in the lower GI, it acts as what could almost be termed a laxative, encouraging the stools prompt passage through the bowels. It is important to distinguish between two general types of blood in the stool. Only blood that originates from the upper GI (i.e. the small intestine) or blood that is issued in excess from the lower GI (rectum, colon, etc.) will cause black stools. It is for this reason that black stools are often associated with bleeding in the upper GI tract or even the stomach. If that is the case, black stools could be caused by a disorder of the stomach such as a peptic ulcer. As a rule of thumb, it takes 14 hours for the blood in stool to oxidize, so black stools are associated with bleeding that originates farther up in the gastrointestinal system.
So aside from black stools, what other symptoms can a sufferer of malena expect to see? Even if sufferers are reluctant to discuss their bathroom habits with their doctors, they may also present with a more easy to discuss problem – anemia. Anemia is characterized by a lack of iron in the blood and can be diagnosed with a blood test. As for the black stools, its presence must be determined by a rectal exam, or a positive stool guaiac test from a lab. A test such as an upper endoscopy may be performed to diagnose the cause of the black stools and determine whether the problem originates from the upper or lower GI tract.
If you are suffering from black stools, you are likely wondering about the cause and are possibly reluctant to consult your doctor. While there is no substitute for being frank and open with your primary care physician, know that black stools are often caused by peptic ulcer disease, but it can also be caused by a patient taking too many anti-coagulant medications, suffering from tumors in the esophagus or the small intestine, or suffering from hemorrhagic blood disease. As you can probably tell just be reading, none of these conditions are conditions that you want to leave untreated. Diseases can spread and worsen and tumors can grow and even turn cancerous. If you are suffering from black stools, forget your timidity and speak with your primary care physician immediately. Believe me when I say that he or she has heard it all before and that you may not be her only case of black stools that week or even that day.
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