By the term tarry stools or melena, physicians understand a clearly visible black coloration of the stool. Depending on the cause, this may be accompanied by health complaints or may occur completely without symptoms. Responsible for tarry stools can be various diseases, but also certain foods or medications.
What is tarry stools?
Tarry stools (melena) are a form of so-called black stool. The term “black stool” refers to any black coloration of the stool. However, if the stool is shiny and very foul-smelling, deep black in color, experts refer to it as tarry stool. This is often an indicator of a serious illness, because the extreme coloring often comes from bleeding in the gastrointestinal tract. However, black stools do not always have to be caused by a disease. Certain medications or foods can also be responsible for the discoloration. However, since under certain circumstances there may be a cause that requires urgent medical treatment, a doctor should be consulted when tarry stools occur.
Causes
Tarry stools often occur when there is bleeding in the upper digestive tract. The blood is then excreted in the stool. The bleeding can be caused by numerous conditions, such as gastritis, stomach ulcers, inflammation of the esophagus, or stomach cancer. If there are varicose veins in the stomach or esophagus, these can also be responsible for bleeding and thus also for tarry stools. Patients with extremely slow digestion unfortunately also suffer more frequently from tarry stools. In principle, however, a black coloration of the stool does not always have to be caused by a disease. Taking charcoal or iron supplements, as well as eating large amounts of blackberries, red wine or red meat, can also lead to a temporary marked discoloration of the stool.
Symptoms, complaints, and signs
The stool of a healthy person is dark brown in color. However, it can also take on significantly darker tones. If it is jet black, it is called tarry stool. The color of the excrement is reminiscent of the pavement on German roads. Often the tarry stool has a dull sheen. Patients sometimes also report that the stool has an unusual foul odor. In addition to appearance, sufferers can be diagnosed with tarry stools if they have a known medical condition. All complaints that cause bleeding in the digestive tract are eligible for this diagnosis. These include stomach ulcers, inflammation of the gastric mucosa or esophagus, or varicose veins. Deep black secretion results from contact of blood with gastric acid or bacteria. Symptomatic of black secretion, however, is also the ingestion of certain foods and medications. These cause a similar looking sputum, but not tarry stools. If, on the other hand, there is pain in the abdomen, nausea and headaches, the suspicion of a disease is confirmed. The tarry stools can thus usually only be recognized by their appearance. Previous illnesses, eating habits and medication intake can only be considered as indications that a serious illness is present. Only an examination of the stool can provide ultimate certainty.
Diagnosis and course
Tarry stools can be diagnosed primarily by examining a stool sample. If blood can be detected in the stool in this way, further comprehensive examinations such as gastroscopy or colonoscopy must take place to determine the exact cause. If no blood is found in the stool sample, a detailed discussion should take place with the affected person, in which, among other things, eating habits, medical history and the use of medication are discussed. The course of the disease depends to a large extent on the actual cause of the tarry stools. If there is a more serious underlying disease, the condition of the affected person may even become life-threatening without treatment. A visit to the doctor as soon as possible is therefore strongly recommended.
Complications
Depending on its cause, tarry stools may cause different complications. If the altered stool is based on a serious gastrointestinal disease, pain, inflammation and other secondary symptoms of the respective disease may occur in the course. Although tarry stools themselves are relatively harmless, their cause can lead to serious complications.In the case of stomach cancer or stomach ulcers, changes in the stool herald a severe course. People with slow digestion often also suffer from constipation and other gastrointestinal complaints in connection with tarry stools. Prolonged tarry stools can also lead to anemia and subsequently to pallor, cold fingers, malaise, and reduced performance and fatigue. Infections of the anus may also occur. Complications can also arise during the treatment of tarry stools. For example, excessive use of charcoal or iron supplements can cause side effects and interactions. Iron tablets often trigger nausea, vomiting, heartburn, diarrhea, constipation, and abdominal pain. Charcoal tablets can cause constipation and, very rarely, intestinal obstruction. Depending on the underlying condition of tarry stools, additional complications may occur as part of the treatment regimen.
When should you see a doctor?
Tarry stools are an indication that bleeding is occurring in the digestive tract. When the blood clots, it is excreted in the stool and stains it dark. The exception is puerperal stool, the first bowel movement in a newborn baby. So if dark stool occurs after this age, it is imperative to see a doctor to determine the cause – even from babyhood. The doctor will first want to know how long the tarry stool has been occurring and whether the stool looks like this regularly or whether it is just an occasional observation. Other complaints and changes in well-being are also important for the doctor treating the patient, as this will enable him to find a possible cause more quickly. The affected person will not be able to avoid a gastroscopy or colonoscopy in the case of tarry stools, because the doctor cannot otherwise identify why bleeding is occurring in the digestive tract. Before that, however, an ultrasound may be used to see if a cause can already be found. If nothing can be seen there, other imaging procedures can also be used so that a targeted search can be made during the subsequent endoscopy and the patient has to remain under anesthesia for a shorter period of time. Even if an underlying condition is known to cause tarry stools, a physician should be consulted as soon as the condition changes or tarry stools occur more frequently than before.
Treatment and therapy
Once the tarry stools have been examined and the cause of the discoloration identified, the attending physician will initiate appropriate therapy. If acute bleeding has been detected in the stomach, intestines or esophagus, it must be stopped. This can be done, among other things, by surgical intervention or directly during a colonoscopy or gastroscopy. This is followed by treatment of the actual cause. If the tarry stools are due to an inflammation in the gastrointestinal tract, for example, antibiotics can be administered to eliminate this. If the esophagus and surrounding tissue have been damaged by an overproduction of stomach acid, acid inhibitors are prescribed to prevent further bleeding from the acid. If cancer is present, surgery is performed to remove the tumor, if possible. Otherwise, chemotherapy can prevent the malignant cells from growing and eliminate the cancer. Especially in the case of acid overproduction or inflammation of the gastric mucosa or esophagus, homeopathic remedies can also be used to gently balance the acid-base balance. However, such therapy should always be discussed with the attending physician, since a pure homeopathic treatment is not sufficient in the case of a severe disease and the patient’s state of health could deteriorate dramatically.
Prevention
Since there can be quite different causes for tarry stools, direct prevention is not possible. However, a healthy lifestyle, a balanced diet, and regular medical examinations can minimize the risk of internal bleeding or gastrointestinal disease. If tarry stools occur and/or associated abdominal discomfort is noticed, a doctor should always be consulted as soon as possible to rule out a serious illness. Tarry stools in themselves are not a disease, but the symptom of diseases of the gastrointestinal tract associated with bleeding. Therefore, follow-up care should be tailored to these diseases. It is best discussed with the internist or family doctor who has also treated the respective disease.
Aftercare
Gentleness of the gastrointestinal tract is an important factor in follow-up care after tarry stools. This can be implemented through a gentle diet. This includes foods that are easy to digest and do not irritate or cause gas. Fatty and spicy foods are just two examples of foods that should be avoided during aftercare. Overly sumptuous meals should also ideally be replaced with small portions several times a day. Drinking is very important for healthy bowel function. Those affected by tarry stools do this optimally with at least 1.5 to 2 liters of water and herbal tea. Non-carbonated water is preferable in this context. Alcohol is also taboo and coffee should only be consumed in moderation. In order to detect bleeding quickly, stool letters are a side-effect-free diagnostic aid that patients can perform on their own at home. This is also an important element in follow-up care. It is important to note that the result can be falsified by certain foods. The package insert provides more detailed information on this.
What you can do yourself
Tarry stools occur when the stool is darkly discolored by blood or dyes in food. If the cause is harmless, patients can do a few things themselves to restore normal stool color. First, a change in diet is recommended. Foods such as licorice, beet or blueberries can darken the stool. If the tarry stools occur without further complaints, an unbalanced diet may be the cause. Long-term abnormalities should be discussed with the family doctor or a nutritionist. It is possible that the tarry stools are due to internal bleeding or a gastrointestinal disease that requires medical treatment. If a gastric ulcer has been diagnosed as the cause, a strict diet must be followed. The patient should not consume fatty foods, coffee or alcohol. Smokers should reduce their cigarette consumption. This also applies if the tarry stools are caused by Mallory-Weiss syndrome or another serious illness. The first step is to stop the bleeding, which requires an examination by endoscope or ultrasound. Depending on the nature of the disease, it may then be sufficient to take medication. In the case of severe bleeding, which may even be due to stomach cancer or major mucosal damage, surgery is required. The patient should take it easy after such an operation and continue to follow a balanced and careful diet. If symptoms persist, a visit to the physician is recommended.
