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What Causes Black Stool or Stomach Pain?

What causes black or tarry stools? Most commonly, black stools are caused by eating certain foods or taking supplements like iron. Other less common causes include intestinal blood located in the upper digestive tract. Read below for associated symptoms like black stool and stomach pain, or other causes and treatment options.

Black and tarry stool symptoms explained

Not everyone talks about it, but everybody does it. Bowel movements can vary in appearance; however, certain presentations can be more concerning than others. Black stool, for example, can be due to something as simple as eating black candy, or something more severe, like an underlying condition. If you notice a consistent dark shade staring back at you from your toilet bowl, be mindful. The color of your stool reflects what's happening internally. Your body makes sure that every morsel we eat is turned into useful energy and gets rid of the rest. When ratios of solid matter, water, blood, bacteria, and other waste are thrown off, the shade of your stool changes. Black stool is usually a sign an excess of blood — but before you panic, consider the variety of causes connected to black stool symptoms.

Common characteristics of black stool

Your black stool will likely present with the following.

  • Dark stool that is either black or dark red in color
  • Bloating or abdominal swelling
  • Discomfort while defecating
  • Burning sensation
  • Loss of appetite

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What makes your poop black

Though there are some severe causes, most instances of black stool can are due to diet changes, viruses, or other non-life-threatening causes. The following details may help you better understand your symptoms and if and when you need to see a physician.

Diet and lifestyle

Black stool causes related to diet and lifestyle factors include the following.

  • False melena: A black stool is a false melena if it is due to eating foods like cranberries, beets, prunes, dark chocolate cookies, or blood sausages.
  • Supplements or medication: Black stool may occur if you take iron supplements or bismuth-containing medication.

Infectious causes

Rotavirus, one type of a viral infection, can cause acute gastroenteritis, or inflammation of the stomach and intestines. This infection can lead to severe diarrhea with black tarry stools, especially in infants and children.

Other causes

Other causes of black stools include the following.

  • Internal sores: Sores, like peptic ulcers or internal tears, can cause black stool if blood reaches the intestines.
  • Internal bleeding: Trauma, like a car accident, can cause internal bleeding. Depending on the location of the bleeding, black stool can be a symptom.

Normal variation of constipation

Constipation means bowel movements which have become infrequent and/or hardened and difficult to pass.

There is wide variation in what is thought "normal" when it comes to frequency of bowel movements. Anywhere from three times a day to three times a week is considered normal.

As long as stools are easy to pass, laxatives should not be used in an effort to force the body to a more frequent schedule.

Constipation is usually caused by lack of fiber in the diet; not drinking enough water; insufficient exercise; and often suppressing the urge to have a bowel movement.

A number of medications and remedies, especially narcotic pain relievers, can cause constipation.

Women are often affected, due to pregnancy and other hormonal changes. Young children who demand low-fiber or "junk food" diets are also susceptible.

Constipation is a condition, not a disease, and most of the time is easily corrected. If simple adjustments in diet, exercise, and bowel habits don't help, a doctor can be consulted to rule out a more serious cause.

Rarity: Common

Top Symptoms: abdominal pain (stomach ache), nausea, stomach bloating, constipation, constipation

Symptoms that always occur with normal variation of constipation: constipation

Symptoms that never occur with normal variation of constipation: vomiting

Urgency: Self-treatment

Stomach ulcer

A peptic ulcer is a sore in the lining of the stomach or the first part of your small intestine (the duodenum), which causes pain following meals or on an empty stomach.

Rarity: Uncommon

Top Symptoms: fatigue, nausea, loss of appetite, moderate abdominal pain, abdominal cramps (stomach cramps)

Symptoms that never occur with stomach ulcer: pain in the lower left abdomen

Urgency: Primary care doctor

Upper gastrointestinal bleeding

The digestive, or gastrointestinal (GI), tract includes the esophagus, stomach, small intestine, large intestine, rectum, and anus. Upper GI bleeding is a medical emergency involving internal bleeding from the esophagus, stomach, or the small intestine.

Rarity: Uncommon

Top Symptoms: fatigue, being severely ill, abdominal cramps (stomach cramps), lightheadedness, rectal bleeding

Symptoms that always occur with upper gastrointestinal bleeding: vomiting (old) blood or passing tarry stools, being severely ill

Urgency: Emergency medical service

Acute gastritis

When something interferes with the protective mechanisms of the stomach, a range of problems can occur from mild indigestion to deadly bleeding ulcers. Gastritis is an umbrella term for one of the most common problems, inflammation of the stomach lining.

Symptoms include nausea or vomiting,...

Chronic gastritis

Gastritis is an inflammation of the lining of the stomach. "Chronic" means it is an ongoing condition that never improves.

The stomach normally contains strong acids to break down food. A layer of mucus lines the stomach to protect it. If the mucus lining is not healthy, the stomach itself can become inflamed.

A common cause of damage is the H. pylori bacteria. It spreads through food, water, and shared eating utensils.

Other causes are nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin; drinking alcohol; or severe physical stress such as injury or major surgery. It may be also be an autoimmune response.

Symptoms include upper abdominal pain and discomfort, with nausea and vomiting. A medical provider should be seen if symptoms persist, as chronic gastritis can lead to ulcers, anemia, malnutrition, and continuing damage to the stomach.

Diagnosis is made through patient history, physical examination, and sometimes upper endoscopy or x-rays.

Treatment involves medications to reduce the amount of acid in the stomach, and treating any underlying cause such as H. pylori.

Rarity: Common

Top Symptoms: nausea or vomiting, stomach bloating, loss of appetite, moderate abdominal pain, mild abdominal pain

Urgency: Primary care doctor

Colonic neoplasm

Colonic neoplasm means "new tissue" growing in the colon, or large intestine. This neoplasm may be either benign (not cancerous) or malignant (cancer.)

The exact cause of any cancer remains unknown. Risk factors seem to be:

Being over fifty years of age.

  • Family history of the disease.
  • A high-fat, low-fiber diet, typical in the modern world
  • Chronic inflammatory diseases of the colon such as Crohn's disease.
  • Smoking and alcohol use.
  • Diabetes, obesity, and inactivity.

The earliest symptoms are usually polyps, small growths within the colon which can be detected on colonoscopy and removed before they can become cancerous. Later symptoms may be unexplained fatigue; change in bowel habits; persistent abdominal discomfort such as gas or cramps; blood in stool; or rectal bleeding.

Diagnosis is made through colonoscopy and sometimes blood testing.

Treatment is done through surgery, which may be minor or extensive; and through chemotherapy with radiation therapy, usually done before and after surgery. Supportive care to keep the patient comfortable is also an important part of treatment.

Rarity: Rare

Top Symptoms: fatigue, stomach bloating, stool changes, diarrhea, constipation

Urgency: Primary care doctor

Stomach neoplasm

A neoplasm, or tumor, can be benign/non-cancerous, or it can be malignant/cancer. Since benign stomach tumors are mostly harmless polyps that often go unnoticed, the term stomach neoplasm usually refers to stomach cancer. Because stomach cancer usually goes undetected until an advanced st...

Acute variceal hemorrhage

Acute variceal hemorrhage is a condition that can occur secondary to (as a result of) liver disease. Blood vessels bringing blood from the digestive tract back to the heart which course through the esophagus (a muscular tube that carries food from the mouth to the stomach) become dilated. In acute variceal hemorrhage, these vessels burst, resulting in internal bleeding.

Rarity: Uncommon

Top Symptoms: being severely ill, abdominal pain (stomach ache), vomiting, constipation, lightheadedness

Symptoms that always occur with acute variceal hemorrhage: being severely ill, vomiting (old) blood or passing tarry stools

Urgency: Emergency medical service

Non specific stool change

There are many factors affecting the appearance of someone's stools. Often a variation in stool color and/or consistency is caused by food or medicines. Leafy greens and certain vegetables like spinach and kale can make stool look green. Iron supplements and medicines containing bismuth like Pepto-bismol can turn stools black. It looks like your stool change is probably a variation of normal.

Rarity: Common

Top Symptoms: black stool, green poop, dark brown stool, red stool

Symptoms that never occur with non specific stool change: tarry stool, weight loss, rectal bleeding, fever

Urgency: Wait and watch

How to treat and get rid of black or tarry stools

Seek help immediately if you have an illness along with black tarry stool. In some cases, colonoscopy or endoscopy is necessary to check for any tears, polyps, or other bleeding sources in the colon or intestines. Unless you are certain that your dark stool is due to your diet, a doctor's visit is recommended.

When it is an emergency

Seek immediate treatment if you are experiencing:

When to see a doctor

If your condition worsens or persists, see a doctor for treatment. He or she may recommend the following.

  • Medications: Your doctor may give you antibiotics or acid-reducing medications, depending on the underlying cause.
  • Surgery: Aside from treating abnormal veins, surgery is necessary to remove polyps or any parts of the colon damaged by cancer or inflammatory bowel disease.

At-home treatments and prevention

If your black stool is due to your diet, consider the following measures.

  • Always drink plenty of water: Skip sugary drinks and stick with water.
  • Avoid food that is blue, green, or black in color: The dyes, whether natural or manmade, can alter the color of your stool.
  • Eat food rich in fiber: Increase your fiber intake and reduce tears in the colon by eating raspberries, pears, whole grains, beans, and artichokes.

FAQs about black stool

Here are some frequently asked questions about black stool.

Can different foods/drinks cause black stool?

Yes, the following foods can cause black stool: black licorice, blueberries, iron supplements, lead, Pepto-Bismol, and charcoal. Iron supplements, beets, and dark leafy vegetable can also darken stool as well as foods that contain blood, like blood sausage or blood pudding. Dark beers and lagers may also significantly darken stool.

Can black stool be caused by dehydration?

No, dehydration does not cause black stool if it is not accompanied by gastrointestinal bleeding. Dehydration may cause sparse, hard, pebble-like stools, and may also darken the color of the stool. Black stools are noticeably darker than the dark brown or dark green stools that accompany dehydration and should be taken seriously as a sign of internal bleeding if there is no other obvious cause.

Why is stool black sometimes?

The stool is black because you have eaten a dark-colored food or food that becomes dark when exposed to stomach acid or bile (see list above). Aside from food, digested blood is black and tarry in appearance, which is concerning [6].

Is it normal for a person to have black stool?

If someone has eaten food known to cause black stool and is not at risk of internal bleeding caused by medication, they may not be at risk. If they have a black stool with no explanation or have a bleeding disorder or predisposition toward gastrointestinal bleeding, then black stool should is abnormal.

Can black stool be caused by stress?

No. Black stool cannot be caused by stress. It is possible for stress to cause an ulcer, for that ulcer to bleed, and for that blood to darken stool, but this is relatively uncommon. Stress in the absence of other conditions does not cause black stools. Conditions that cause black stool, however, can cause stress or place stress on the body. A bleed in the gut can also cause fatigue and irritability in some.

Questions your doctor may ask about black stool

  • Have you experienced any nausea?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Any fever today or during the last week?
  • Have you had any changes in your weight?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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