# Help! Dark coloured stool



## mikan92

I have been on movicol for 4 days to get the stool that has been "stuck" in my intestines out as ordered by my GP. I increased the dosage to 2 sachets 2 days ago and was able to pass more out (though my stool became more loose). However I do realise the colour of my stool turned slightly darker from yesterday, it was quite a dark, greyish brown. Today the stool turned even darker and became almost black (though not the charcoal black but very dark brown such that it's like blackish in the toilet bowl). It's not stick or different in texture from previous ones but it's the first time I've seen this colour in my stool. I've read online that it can be caused by internal bleeding which really freaks me out. Should I consult a doctor immediately or wait till next morning to see if it appears again?

I took movicol after lunch and dinner, and will wake up past 7 the next morning because of the urge to go toilet. I will have abdominal pain even after passing stool and it can stay till afternoon. Is this normal for movicol or is the dosage too high for me?

p.s I just started taking a pill of fish oil (600mg) the day before, not sure if this could be related?


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## annie7

HI Mikan

there are a number of things that can cause stool to darken such as the length of time it's been in the colon (gets darker the longer it is in there) as well as what you eat--dark green food like green beans, spinach, kale, beets or beet juice etc. it could be the fish oil pills, too. dark red can be an indication of blood. the best thing to do is call your doctor's office and tell them about it. that way can can get professional advice about what it could be and if you need to make an appointment.

movicol can cause gas, bloating and pain. i don't take it a lot but when i do, i get often pain like that--sometimes all day long--especially if i take a lot of it. you might want to try reducing the dose and see if that helps.


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## mikan92

Hi Annie,

Thanks so much for your reply, you are really helpful 

Ya I'm guessing it can be those poop that had been stuck inside my system for a while. I'll just discontinue the fish oil and see if there is any chance, or else I'll consult with my doctor as I'm seeing her on Thursday.

I'm just going to take 1 sachet tonight. Feel like my body doesn't tolerate all the laxatives well, I can only take the mild ones but it seems like they are not strong enough to clear my system 

Do you mind sharing more of your experiences? I'm all new to constipation cause I never had a major issue (or at least that is what I thought) until this one, which seems to suggest that I might be having subtle constipation for a while despite having bowel movement almost every morning ( since the doctor mentioned that I'm quite "full" upon pressing on my tummy). Really desperate to clear this cause I can't resume my supplements routine yet with constipation and I really want to because I need the supplements for my other prob  Sorry for rambling!


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## annie7

oh, thanks--you're more than welcome.









i've had constipation problems for many years, since childhood, when they got worse in my early 20's, i saw a doctor (GP) and was given an ibs-c diagnosis and told to drink lots of water, eat lots of fiber (which only made me worse) and exercise.

and yes, whenever doctors felt my abdomen, they always said i felt "full of stool" despite the fact that i did manage to go somewhat every day--i just couldn't evacuate fully and always felt that there was more stool stuck inside my rectum and higher up.

finally, after reading this board, i realized that i might have more going on than ibs-c so i found a good gastro doc and had some tests--a colonic transit test (sitz marker test) during which time i didn't go at all and passed no markers. because most of the markers were in my rectum and sigmoid colon, my gastro had me take a defecogram (defecatory proctogram). this showed, as he suspected, that i had outlet problems--pelvic floor dysfunction and a medium size rectocele.

for the pfd, he referred me to biofeedback which did help me learn to relax those tight pelvic floor muscles but because i have other problems down there--rectal hyposensitivity and megarectum as dx'd by an anal manometry--biofeedback was not the whole solution.

i have two gastro docs now (because i'm complicated lol) and they both tell me to take whatever i need to go. which, having tried everything else to no avail, means i take a stimulant laxative (dulcolax) every night and an osmotic (milk of magnesia--taken a few hours after the dulcolax, not with it as that causes cramping). i also use suppositories as needed and sometimes add in a half dose or so of miralax. all these laxatives are not an ideal solution--a last resort, really--but at least they help me go. otherwise i get impacted.

i also have found that elevating my feet on a squatty potty (or you can use a footstool, shoe box etc) while sitting on the toilet helps. doing this straightens out the anorectal angle and allows a more complete evacuation.

that's good you will be seeing your doctor thursday. do you have a good gastroenterologist? hopefully your GP can help but if not, ask for a referral to a good gastro doc.

good luck with everything.


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## annie7

about fish oil supplements: i do remember some posts from people saying that taking fish oil supplements darkened their stool. and some people say that these help with their C .

i take them but never noticed any stool-darkening effect or any help with my C, but that's me. maybe it depends on the type and brand of fish oil supplement.


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## mikan92

Hi Annie!

Thanks for sharing your story! I'm sorry for what you have been through  Hopefully you'll find something that works better for you soon!

I'm trying your method of elevating my feet when I go to the toilet and I think it helps 

My dark coloured stool was just the old poops I think! I've been taking fish oils these days and my stool colour is fine, phew!

I don't have a GI doctor,wondering if I should see one. I just saw my GP today and she said there ares still some stools in there, had me do a X-ray and confirmed this. So I will need to continue my medication for a week and get back to her. Apparently I am chronically constipated even though I never had major signs of constipation, only when I go to a new environment I cannot seem to have good BM but other times it's pretty regular


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## annie7

thanks, Mikan...









glad you're having some success with elevating your feet. it can take some experimentation to find which height works best for you. i started with a shoe box and now use a squatty potty. some people find that using two shoe boxes--one for each foot--(or a real long foot stool)--works better than one shoe box. it gives you a wider stance.

it sounds like your GP is being quite thorough with the x-rays and follow up appointment but you still might want to consult a good gastroenterologist--especially since, as you mentioned in your other post, you now have GERD (reflux) as well. like i said on your other post, i'm a bit surprised your GP doesn't want to help you with your reflux right now..

i have constipation problems all the time but for me it definitely does get worse when i travel or am in a new environment. have you recently moved? can't remember if you've mentioned that in another post or not. if you have, hopefully things will settle down and resolve one you've adjusted.


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## mikan92

Hi Annie!

Haha that's interesting! Using your method everyday and I can feel it makes my bowel movements easier 

I've got the Xray report and it said I have lots of stool in my system which confirmed my GP's diagnosis. After taking 2 weeks of movicol with much improvements, my GP told me to switch to fibre supplements (benefibre) and that I don't have to go back unless I dont get well. So far I don't really notice its effects yet. It's so hard to stick to a high fiber diet esp when I'm also on low oxalate diet 

Just wondering if you have tried herbal or natural laxatives? Are those not strong enough for you? Yup I kind of moved cause my uni started & I guess my constipation was largely due to stress also.


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## annie7

glad to hear things are moving better with the foot elevation and movicol. and hopefully the benefiber will help, too.

oh yes--i've tried herbal laxatives--a lot of different ones. some used to work but don't anymore and others never helped at all. but yes, they can be very effective for many people.


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## mikan92

So far the benefiber isn't working very well, I definitely feel not as good after coming off movicol  Maybe I should drink more sachets of benefiber.

Is it because herbal ones aren't as strong? I think I will go to TCM or other alternative medicines and see if they have something for me. Guess being in a stressful period is also affecting my bowel movement


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## annie7

sorry benefiber isn't helping.

quite a few of us here have found that sometimes more fiber isn't the answer. if your constipation is caused by a lack of fiber, then fiber can be helpful but for people with a colon that is a little slow, adding more fiber only makes things worse.

can you go back to using movicol, since that was helping?

have you tried magnesium supplements? some people find taking magnesium supplements helps. the amount and which type of mag supplement varies from individual to individual. you have to experiment to see what works for you. there are many different kinds: magnesium citrate, magnesium oxide, magnesium glycinate, chelated magnesium, liquid magnesium citrate (the supplement--not the stuff in the bottles you buy at the drug store) etc. a lot of people like powdered magnesium supplements like natural calm- you mix in water and drink it . Magnesium relaxes the muscles in the intestines which helps to establish a smoother rhythm and magnesium also helps soften the stool by attracting water to the colon which helps to make stools easier to pass. we've got a ton of magnesium threads on here.

about the herbal laxatives---i don't know if it's a question of strength or not. exlax (senna) has a maximum strength variety and senna tea can be quite strong. i do take cascara sagrada, another plant based laxative, which works for me. and i also take bisacodyl (ducolax--not an herbal) . some people say drinking various types of chinese slimming teas (diet teas) helps them go. most of these teas have senna in them.

some people have found that Dr Schultz's intestinal formula #1 works well for them. this has a number of different herbal ingredients--basically laxatives and stool softeners. here is Flossy's recent thread on it and i posted a link to the list of ingredients in it, if you're interested.

http://www.ibsgroup.org/forums/topic/239065-finally-a-product-i-can-recommend/

and yes, that's a good idea to give TCM a go. some people here have had good success with it.

you could also triphala. that's a herbal laxative, too. some people have had good luck with that.

and oh yes--stress, moving and exams can all make constipation worse. it does for me. hopefully when exams are over and things settle down a bit, you constipation will improve as well. in the meantime, maybe try some stress reduction or relaxation techniques...


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## annie7

we also have this thread, "the great list of remedies". it has a lot of natural constipation relief ideas in it:

http://www.ibsgroup.org/forums/topic/152106-the-great-list-of-remedies/


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## mikan92

Movicol helped a lot at first but towards the end of second week my bowel movement was less, though I felt less bloated and full but never a sense of full evacuation. I think my doctor wants me off laxatives in case I develop dependence and switch to more natural way of managing.

What you said made me wonder if mine is simply a fiber prob or even a fiber prob at all! I do know that my fiber intake is not ideal (less than recommended) but before I had constipation my diet was also like that. My stool is always soft and more like diarrhoea-ish. I feel like my constipation is more like slow colon/colon not pushing the stool down. I can feel there is something there, but they just dont come down! Even when I was taking movicol I can feel I want to pass the stool but my colon isn't cooperating  I have to go 2-3 times in the morning with passing bits sometimes.

With this new realisation (lol), I think I should really try magnesium! Not sure if multi-vitamins or calcium supplement I'm taking is causing the prob but really don't want to stop them cause they are helping me with another prob.

I think Senna and ducolax are not my good friends I've had bad reactions to them! It's good that ducolax is helping you  Maybe I'll consult a TCM doctor and get a herbal tea too 

I was planning to get Dr Schultz's products but since I live in Aus I need to wait for 3-4 weeks for it to come (via ebay)! Gonna order it anyway, but I need to find something to help my bowel movement while waiting for it to come. Have you tried any yet?

I'll look into triphala too!

Yes that's what I'm hoping too! Doing deep breathing and stuff, can't wait for exams to be over XD

& THANKS SO MUCH for the link I'm reading through the posts  I'm gonna try prune too. This forum is so helpful


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## annie7

some of us do have slow moving colons. a test that will diagnose colonic motility problems is the sitz marker test (colonic marker study) . not that many of us need that test to tell us that we're slow lol but sometimes it does help to have the test to make it all "official"--at least, as far as the doctors are concerned. plus it will show if the entire colon is slow or if there are specific problem areas.

yes, do try the magnesium. it really can help.

i take calcium, too, because i have osteoporosis. calcium carbonate can be constipating. i take calcium citrate because that form of calcium is not constipating. it's better absorbed than calcium carbonate. plus i take a low dose tablet of it--250 mg one or two times a day. i've read that for best absorption (and also for less of a C side effect), it's best to take no more than 500 mg of calcium at a time.

also--too much iron can be constipating. when i was younger, i took a multivitamin with some iron in it because when we're young, we ladies need the iron. my multivitamin wasn't really heavy on the iron--it had just the right amount-- so it didn't make my C worse. now i'm post menopausal (i'm old lol) so my multivitamin has no iron..

you can buy chinese slimming or diet teas on amazon but yes, a TCM would be a good source and would probably have much better teas and chinese herbs than what you can buy online.

yes, i tried Dr S. it didn't really do much for me but that's me--i'm complicated. good luck with it when you get it.


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## mikan92

I take calcium citrate too! only one pill at a time with meal  glad to know this form doesn't cause constipation.

My multi-vitamin does not have iron in it, so I guess it's okay. I just did a blood test recently and my Iron level etc was all normal, so I guess I don't need iron supplements (phew). It's hard to figure out the right amount of supplement, my mom always warms me about not over-dosing myself with all the supplements cause it does have side-effects  we don't need as much iron after menopause?

I think the fibers are helping, but I still can't get the sense of complete emptying yet  Hopefully my system can get gradually cleared while I increase my fiber intake.

Hope you are doing well too


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## annie7

oh, I hate that incomplete emptying feeling...

that's good your iron levels and everything are ok. no, after menopause we don't need as much iron because we no longer have periods then--some iron is lost with the monthly blood flow...

that's good the fiber is helping.

i'm hangin in there more or less lol...


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## mikan92

me too 

I see... apparently soluble fibre is more for people with diarrhoea or loose stools? Maybe my GP asked me to take cause I told her my stool is loose, but they are becoming more "normal" now. Still can't get the relief yet though :x might need to go back to GP cause I've been getting lots of gases recently 

Lol is your bowel movement more or less okay with the current management?


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## annie7

Yes i think soluble fiber is usually recommended for people with diarrhea. I find i do better on a low fiber diet but that's me.

On my current management..well...good days and bad. Used to be better than it is now. ...lol..


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## mikan92

Hmmm I'll try cutting down my fibre a little cause I'm getting so gassy these few days  Can't do magnesium too cause I've heard some ppl get bloated from taking magnesium.

I find that the effects of laxatives are not consistent... Movicol helped me on some days at first but started to lose its effects  It's so hard to find a long-lasting good solution


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## annie7

yes, it can be hard to find a long lasting solution, unfortunately.

over the (many) years, my problems have become somewhat of a moving target. some things i've tried don't work at all, some work for a few years only, others work a bit longer but then wane in effectiveness or the side effects seem to get worse. i think some of my problems now have to do with age (i'm ol lol--63) . all this sure keeps you on your toes....

but yes--play around with your diet or with the fiber supplements. try less fiber, try different types of food fiber (some people find flax seed or ground flax seed helps) or fiber supplements etc. good luck with everything.


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## mikan92

That's true.... I know it's early for me to say I'm aging but I do feel the need to take care of my body compared to few years ago. It's funny that even for the same type of laxatives one works and the other don't, it's really a matter of trial and error which is not fun  Lol but you are an active 63 yr old 

Thanks! Good luck to you too XD


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## mikan92

Btw, if remember correctly, you mentioned you had impaction before? Just wondering how is it like & how will the doctor diagnose? Thanks


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## annie7

I had an obstruction (not an impaction) a couple years ago when I took my first sitz marker test, which means you have to go off all laxatives for a week.

I didn't have a BM at all for five days. felt quite ill, nauseous and had a lot of abdominal and rectal pain, cramping. I wanted to finish the test but instead went to the ER when I found I could no longer urinate. the nurse pumped a liter and a hlf of urine out of me lol--it was that bad.

the doc can tell if you are impacted or obstructed with an abdominal x-ray, which shows how much stool is in the colon and how dense it all is--ie: mild stool, dense stool, fecal loading.


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## mikan92

Hi Annie!

Exam is almost over (Yayyy!!). That's horrible, I'm sorry it happened to you  But why did it affect the urination?

I guess it means I'm not impacted because the Dr did not make such comment on viewing my X-ray, unless she wasn't paying attention (hopefully not).

I've just seen a TCM practitioner today, he did acupuncture and abdominal massage and gave me some herbs! Hope things will actually work this time & the root problem (the practitioner said there is lack of energy there lol), and not just symptoms. Hope things are going well with you too!


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## annie7

i think the obstruction made me stop urinating because i was just so full of stool in my rectum and sigmoid colon that it blocked off my urethra. or something like that. the x-ray showed that i was just loaded with stool in that area.

oh i do think that your doc would have paid attention to the x-ray and noticed if it said you were impacted. the radiologist includes his/her report on the x-ray and states if you have stool present and the amount of the stool (mild, moderate or fecal loading) and the location of the stool ( most in just one area or through out the entire colon). you could always get a copy of the x-ray. (if they allow that in australia) . my hospital has my x-rays and tests and procedures online for me to see through my "patient portal" which is really handy, or you can request a copy.

oh that's great news that you saw your TCM practitioner! sounds like he was very thorough. they really do know a lot about how the body works and pay attention to your whole body and how it is affecting things. and oh yes--i can certainly see how a lack of energy in that region would certainly bog things down ...lol....

fingers crossed the herbs will do the trick. i've read posts from people who said chinese herbs helped them. and quite a while back, i read a study about the effectiveness of a particular chinese herb in treating constipation--wish i could remember the name of it...


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## mikan92

I see.... Hope this will never happen to you gain :x

Yes I do have the hard copy of X-ray but I can't really tell which ones are the stool lol. I don't have the report but I remember it saying faeces in colons etc, but can stool be located in the small intestines as well (sorry if this is a stupid question)? Wow that's cool! Do you get access to the report too?

Wasn't expecting acupuncture for constipation though! Have you tried acupuncture for your conditions before?

I don't know what herbs he gave me, should ask him on my next session! Besides the herbs he asked me to take magnesium morning and night, I took 1 and a half scoop (equivalent to around 450mg, he asked me to take 2 scoop but the instruction on the bottle said to take 1 scoop at a time), and I woke up at 2am with stomach cramp and had to go to toilet. In the morning I also had to get up because of stomach cramp and I had diarrhoea - mostly passing liquid without much proper faeces. Do you think magnesium is the cause, because I took too much? Sighs, I am really getting sick and tired of this cycle  Not being able to pass much, or passing lots of liquid  Gonna try cutting it down today and see how it goes


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## annie7

so sorry about all the cramping and diarrhea. yes i think it's probably the magnesium and yes, cutting down the amount is a good idea. sometimes people have to play around with the dosage to see what works best for them.

and oh yes--cycles like these are frustrating, aren't they.

yes, it can be hard for us laypeople to actually be able to tell from looking at an x-ray just where the stool is and how dense it is. i couldn't tell from that x-ray i had for the obstruction. it was a KUB x-ray and hard for me to read. the x-ray tech had included his report with the actual x-ray and that's were i got the information--from his written report.

my other abdominal x-rays that i saw on my patient portal online just contained the written report only, not the x-ray itself, which was fine with me.

(and oh no--no questions on here are ever stupid







.. never. questions are what the board is for )

The small intestine is the part of the intestines where 90% of the digestion and absorption of food occurs, the other 10% taking place in the stomach and large intestine. The main function of the small intestine is absorption of nutrients and minerals from food. so stool is liquid when it passes from the small intestine into the colon. after it enters the colon, it becomes formed and solidifies. the colon removes a lot of the water from the stool and gradually pushes it along to the rectum.

so no--you wouldn't be seeing formed stool in the small intestine. i don't think liquid contents (stool) show up on an x-ray. i asked one of my gastros this question and he said no, he didn't think it did.

an x-ray will show gas and gas pockets, though.

i never tried acupuncture for my constipation because i was unable to find a reputable acupuncturist in my area that i could afford (insurance won't pay). a friend of mine who lives in another state tried it though, for her constipation. she thought that maybe it was helping.. she did say it was very relaxing. i do think it's well worth a try.

good luck with everything. hope the lower magnesium dose does the trick.


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