Be true to your stool: Monitoring can provide a key, early warning

It's because I care about all of you that I ask that you bear with me when reading today's column.

My friend the nurse recently related a story about one family member diagnosed with colon cancer and another with a bleeding ulcer; both of whom supposedly had no symptoms. My initial reaction – “didn't they notice a change in the makeup of their bowel movements?”

She replied “No. You would be surprised how many people never look at their stool.”

Dealing with Crohn's disease has made bathroom monitoring second nature in this house, so I was surprised after taking a poll of close friends and family (and one should only take this poll with close friends and family) to learn that most people don't have a clue about their stool.

Stool can present in a wide range of colors, most of which are considered normal. It's mostly influenced by what you eat or by the amount of bile (a yellow-green fluid that digests fats) in the stool.

The term for stool that is black, looks like tar and is usually foul-smelling due to the presence of blood is “melena.” The dark color indicates the blood is coming from the upper part of the gastrointestinal (GI) tract, namely the esophagus, stomach and beginning of the small intestine.

The darker the stool due to blood, the longer it has been in the GI tract, which becomes a diagnostic clue for the doctor.

Some common medical causes for black stools may include a bleeding stomach or duodenal ulcer, gastritis, trauma or a foreign body in the GI tract, or a tear in the esophagus from violent vomiting (Mallory-Weiss tear). On the other hand, the stool may be black due to non-blood related causes (false melena) such as ingesting black licorice, iron supplements, Pepto-Bismol or blueberries.

Bright-red or maroon colored stools, termed “hematochezia” usually indicates the presence of blood that is coming from somewhere in the lower GI tract (large intestine, rectum or anus). When bleeding from the GI tract is very slow, it may not be visible to the naked eye, and it is then termed occult blood.

That's why we need a fecal occult blood test yearly after turning 50. Green-colored stool might indicate that it moved through the GI tract too quickly and bile wasn't broken down. If it's white or clay-colored, it could mean a lack of bile indicating a bile duct obstruction.

Some possible causes of maroon or bright-red stools include hemorrhoids, colon polyps, colon cancer, Diverticulosis, Crohn's disease or Ulcerative Colitis. Some nonmedical causes include ingesting red Jell-O, Kool-Aid, beets or tomatoes.

If you monitor your stools, you can notice a change as soon as it occurs. So get organized with the following health tips to get the scoop:

Notify your doctor if you have any change in bowel habits that persist for more than two weeks.

Monitor color, consistency and shape. Narrow, pencil-like stools may indicate an obstruction.

Provide a good history by noting if you are taking NSAIDS (i.e. ibuprofen) or blood thinners, if you've had unexplained weight loss, or trauma to the abdomen or GI tract.

Note if other symptoms are present and when they began (abdominal pain, vomiting blood, diarrhea).