Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
It is reasonable to have an obsession with one's bowel movements. The
quality, quantity and color of stool may be an indicator of gastrointestinal
system's health and should the stool change color, it may provide a clue as to
what might be wrong.
Stool, feces, or poop is the waste product of digestion. Food mixes with bile
from the liver and digestive enzymes from the pancreas allowing protein,
carbohydrates, and fats in the diet to be broken down to form a slurry. This
liquid mixture passes through the small intestine where nutrients are absorbed
into the blood stream and the liquid waste is delivered to the colon. In the
colon, water is absorbed and stool is formed. Normal stool contains bacteria,
digested food, cellulose from undigested plant material, and bile.
Normal stool color can range from light brown to dark brown to green. Often
the color of stool is affected by what has been eaten, and may not signify any
potential illness or disease. However, it is possible that the color of the
stool can provide important clues to an underlying disease.
A diagnosis cannot be made by stool color. The patient and the health
care professional need to consider other symptoms, past medical history, dietary
changes, and medications to help decide what has caused the stool to change
color. Physical examination will be important to help decide the significance of
the stool color.
Stool may be tested to look for blood, fat or infection. Blood tests may be
necessary depending upon the clinical situation.
If stool passes through the intestine too quickly, there might not be enough
time for bile to be digested and broken down to provide the normal brownish
stool color. Bile is a greenish brown fluid that is manufactured in the liver and
stored in the gallbladder. Bile helps digest fats in food. It takes time for the
bile to degrade and turn brown in the intestine and if the transit time is
short, the stool remains green colored. This is why diarrhea is often greenish
Green stools may be a normal variant. It can also be caused by a diet rich in
green vegetables, especially spinach. Iron supplements also may be a cause,
though it often turns stool black.
It started with feeling a little run down after working extra hard, perhaps
there was some lightheadedness when he stood too quickly, and then came the
fatigue. The baseball world blamed Ichiro Suzuki's malaise on playing too
much in the World Baseball Classic. During spring training, baseball players are
supposed to lounge and gradually get themselves into shape,
not play like it's the World Series in October. But the baseball world was
wrong. It was discovered in April 2009 that Ichiro was tired because he was
anemic and because
he was bleeding from an ulcer.
The scenario plays out routinely off the playing field too often. A person
feels run down and blames it on all sorts of circumstances, but finally goes
to their doctor to get some help. The clues come from the history of heartburn
and indigestion, or maybe it was the extra aspirin or ibuprofen to help with
the stress headaches at work. There may be a little tenderness in the belly, and
after some coercion on the part of the doctor, the patient agrees to a rectal
exam. It shows that the stool has occult blood in it
(rectal bleeding); that is blood that cannot
be seen with the naked eye but shows up with a chemical test. A blood test (CBC) shows
that the patient is anemic, meaning there is a low
red blood cell count. Put the
clues together and the doctor tells the patient that the fatigue and tiredness
is due to bleeding.