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Date of last update: 10/15/2017.

Forum Name: Gastroenterology Topics

Question: Not H.Pylori causing black stool...what could it be?

 lilonething - Tue Jul 24, 2007 10:01 am

Background: I'm a 30 year old female with life long stomach discomfort due to constipation. I recently had 5 days of black tar coloured smelly stool (about three weeks ago). This happened about 6 months ago too, but I thought I had the flu. Both times, I had heart burn, food tasted funny, and I had a raw gnawing feeling in my chest. He tested for H.Pylori and it came back negative. I am also not anemic. He doesn't seem concerned about it at all, but he is going to send me to a GI to see if a scope is necessary because I had a bit more black stool two days ago (Not much).
Questions: My symptoms sound like an ulcer but I don't have the bacteria and I don't take NSAIDS. I take no medications at all, not even BC. What could cause the black stool if it isn't an ulcer? Do people ever bleed despite having no real problem, or does the absence of H.Pylori mean I have a larger problem? Do stomach bugs ever cause black loose smelly stool? Finally, what does a scope involve, and does it hurt?

Thanks for your time.
 Dr. Chan Lowe - Mon Jul 30, 2007 10:11 pm

User avatar Hi Lilonething,

Black, tarry stool is usually indicative of blood in the stool that has been partially broken down through the digestive process. This generally indicates it is coming from a higher up source and not the lower intestines.

As you have indicated, ulcers very commonly will cause this and H. pylori is a well known cause of ulcers. However, ulcers can occur in the absence of H. pylori.

Ulcers are one of the more common causes of bleeding. Severe reflux, in itself, can cause inflammation of stomach/esophageal lining which can bleed. Also, inflammatory bowel diseases can do this (more typically Crohn's as the source is usually not the colon).

Seeing a GI specialist is a good idea. An endoscopy is really quite simple. Generally, the GI specialist will give you some medicine to relax you and help you not remember the event. Then a small camera that looks kind of like a garden hose (but smaller) is inserted through the mouth and down the esophagus into the stomach and first part of the intestines. The specialist will directly look at the mucosa of these areas for any signs of ulcers or other problems. Biopsies (very small) will also be taken to send for microscopic analysis. The whole procedure is usually no more than 30-45 minutes long.

Usually, the endoscopy is quite helpful in determining what the cause of your symptoms is.

Best wishes.
 lilonething - Mon Jul 30, 2007 11:36 pm

Thank you so much for your detailed reply. You've really put my mind at ease because I know what to expect.
 lilonething - Thu Aug 16, 2007 8:33 pm

Sorry to write again. I have lots of questions lately!

I just received a phone message for my referral to a GI specialist for "screening for a colonoscopy". My question is why would it be a colonoscopy and not the endoscopy you mentioned, which seems to make more sense since the blood apparently comes from high up in order for it to have turned black. If the black tarry stool and heart burn are the new symptoms and the constipation and bloating is life-long, will he still be able to see what is causing the new symptoms with the colonoscopy? Is it any more/less painful then the endoscopy?

Thanks for your time.

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