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Black Stool

Black stool usually means that the blood is coming from the upper part of the gastrointestinal tract. The blood might be coming from the esophagus, stomach, and the first part of the small intestine. Blood will typically look like tar after it has been exposed to the body's digestive juices. Stomach ulcers caused by ibuprofen, naproxen, or aspirin are common causes of upper GI bleeding.

Common causes of black stool are:

  • Bleeding stomach or duodenal ulcer
  • Gastritis
  • Mallory-Weiss tear (a tear in the esophagus from violent vomiting)
  • Trauma or foreign body
  • Bowel ischemia (a lack of proper blood flow to the intestines)
  • Vascular malformation

Other causes of black stool include:

  • Consuming black licorice
  • Consuming lead
  • Consuming iron pills
  • Medicines (Pepto-Bismol)
  • Eating too many blueberries

Melena is a term used to describe black, tarry, and foul-smelling stools.

What to do when you have Black Stool

Talk to your doctor. Your doctor will want to know the exact color to help find the site of bleeding. Your doctor will probably perform an endoscopy or special x-ray studies.

Information for your doctor

When you visit your doctor, they will take a medical history and perform a physical examination, focusing on your abdomen and rectum.

The following questions may be included in the history to better understand the possible causes of your bloody or dark stools:

  • Is there blood on the toilet paper only?
  • What color is the stool?
  • When did it develop?
  • Have you had more than one episode of blood in your stool? Is every stool this way?
  • Are you taking blood thinners or NSAIDs (ibuprofen, naproxen, aspirin)?
  • Have you ingested black licorice, lead, Pepto-Bismol, or blueberries?
  • Have you had any abdominal trauma or swallowed a foreign object accidentally?
  • Have you lost any weight recently?

Treatment for Black Stool

Treatment depends on the cause and severity of the bleeding. For serious bleeding, you may be admitted to a hospital for monitoring and workup.

Prevent Black Stool

You can help prevent black stool by:

  • Reduce your risk of constipation, hemorrhoids, diverticulosis, and colon cancer by eating vegetables and foods rich in natural fiber and low in saturated fat.
  • Avoid prolonged, excessive use of anti-inflammatory drugs like ibuprofen, naproxen, and aspirin.
  • Limit alcohol intake. Large amounts of alcohol can irritate the lining of the esophagus and stomach.
  • Do not smoke. Smoking is linked to peptic ulcers and cancers of the GI tract.

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