Causes and Management of Black Specks in Stool

Introduction

The composition of feces includes a mixture of water, undigested food material (primarily fiber), mucus, and bacteria. Typically, feces appear brown because of the breakdown of bile by intestinal bacteria. However, there may be instances when the color of the feces changes. Since diet plays a significant role in the fecal formation, black spots in feces are often related to dietary factors. Nonetheless, there are exceptions to this. Black specks or dots may indicate old blood within the gastrointestinal (GI) tract. As blood in the feces can be a serious medical issue, it is crucial to know when to be concerned about black specks in the stool.

What Causes Black Specks in Stools?

Black specks found in the stool or after wiping can generally be attributed to one of two factors, a dietary source or bleeding within the gastrointestinal tract.

1. Food or Medication-Related Factors: Incomplete digestion of certain foods can lead to the appearance of black specks in the stool. Examples of such foods include:

• Bananas.

• Blueberries.

• Cherries.

• Figs.

• Foods that are artificially darkened with food colorings, such as chocolate puddings or licorice candies.

• Herbs and spices like black pepper or paprika.

• Plums.

• Red meat, particularly when undercooked.

• Undigested seeds, like strawberry seeds or sesame seeds.

Consumption of iron-rich foods can also contribute to the development of black-colored stools or specks in the stool. Oysters and kidney beans are some examples of such foods. Additionally, taking iron supplements may lead to black or greenish-black stools with specks.

2. Serious Cause: In some cases, the presence of black specks in stool can indicate a more severe underlying issue, such as bleeding in the gastrointestinal tract or an infection caused by parasites.

• Gastrointestinal Bleeding: At times, black specks may resemble the appearance of coffee grounds. Typically, the darker the color of blood in the stool, the farther it has traveled through the gastrointestinal tract. Physicians often associate bright red blood in the stool with lower GI tract bleeding, whereas darker blood is indicative of bleeding in the upper GI tract. Inflammation, a laceration, or a malignant growth can result in bleeding in the upper GI tract. Ingesting certain medications classified as nonsteroidal anti-inflammatory drugs (NSAIDs) can occasionally lead to irritation and bleeding, which can result in the presence of black specks in the stool. Examples of such drugs include Ibuprofen.

• Parasitic Infection: Parasites are organisms that depend on a host organism to survive. They can be transmitted through a variety of means, including contaminated water, food, soil, feces, and blood. Parasitic infections can cause black specks in the stool in a few different ways. Certain types of parasites, such as hookworms and whipworms, have the ability to affix themselves to the intestinal wall and nourish themselves on blood, leading to bleeding in the digestive system. This can result in the appearance of black or tarry stool due to the presence of partially digested blood. Other parasites, of specific types, can induce inflammation and harm to the lining of the intestines, resulting in bleeding and the presence of black spots in fecal matter. Parasitic infestations may also give rise to gastrointestinal indications such as diarrhea, abdominal discomfort, and other related symptoms.

• In Children: In infants, meconium is the primary cause of dark, sticky stools. This is because they lack the beneficial gut bacteria that aid in digestion and bowel movements, which results in a dark-colored stool. Following birth, the infant's gut gradually becomes colonized with bacteria over the first few days, and the stools become lighter. In babies older than a week, the black stool is unlikely to be meconium.

The reasons for black specks in the stools of older babies are similar to those in adults. However, since infants are more vulnerable to infections and illnesses, it is critical to notify a pediatrician immediately of any changes in their stools. If a baby exhibits the following symptoms, they should be immediately taken to the emergency room:

1. Fever.

2. Vomiting.

3. Lethargy.

4. Gas.

5. Obvious discomfort along with black specks in their stool.

What Are the Treatment Options Available?

Treatment for black specks in stools depends on the underlying cause. If a person can remember what they have eaten in the last 48 hours and identify a food that may cause black specks, eliminating that food from the diet and monitoring the situation may be helpful. In cases where a person is taking medications that are known to cause irritation or bleeding in the gastrointestinal tract, consulting with a doctor to ascertain whether it is secure to discontinue the medication is recommended to ease the discomfort.

• Gastrointestinal Bleeding: Medical attention is necessary for black specks in stool caused by gastrointestinal bleeding. Medical history and symptoms will be reviewed by a doctor who may order laboratory testing such as a complete blood count to check for low blood counts which could indicate gastrointestinal bleeding. They may also request a stool sample and perform a test in-office using a hemoccult card to detect blood in the stool. If blood is found, a colonoscopy or an esophagogastroduodenoscopy (EGD) may be recommended. An EGD is a procedure that entails using a slender, illuminated camera inserted through the mouth to inspect the upper gastrointestinal tract, while a colonoscopy involves utilizing a comparable instrument inserted through the rectum to observe all areas of the colon and detect sources of bleeding. If bleeding is identified, the doctor may use special tools to stop the bleeding. Treatment recommendations will be made if findings suggest inflammatory bowel diseases (IBD), such as Crohn’s disease or ulcerative colitis.

• Parasitic Infection: If a parasitic infection is suspected by the doctor, the patient may require to undergo a blood or stool examination. Parasites are typically treatable using medication.

When to Consult a Doctor?

Medical attention should be sought if black specks in the stool are accompanied by other concerning symptoms such as abdominal pain, diarrhea, constipation, nausea, vomiting, fever, weakness, fatigue, or unintended weight loss. Additionally, if the black specks persist for more than a few days or are accompanied by rectal bleeding or significant blood loss, it is important to consult a doctor immediately. A pediatrician must be contacted right away if a baby or toddler exhibits other alarming symptoms, such as black flecks in their feces.

Conclusion

There are various reasons why black spots may appear in feces, which may include dietary habits, medication, and underlying medical issues such as intestinal bleeding or parasitic infections. It is important to seek medical attention if the black specks persist or are accompanied by other symptoms such as pain, fever, or vomiting. Consulting with a doctor can help identify the underlying cause and determine the appropriate treatment.