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Posted on Mon, 3 Jul 2017 in Digestion and Bowels
Question: Hi Doctor! Past two weeks my stool has become harder, black and some green fuzz. I have eosinophiliic esophogitis and am on on omeprozole. I have gotten some stomach pain some back pain. Was at the doctor office two months ago and liver panel fine full ct Scan as well no issue. Colonoscopy 3 months ago and it was perfect. Not sure what it could be?
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Mild bleed from esophageal mucosa most likely.

Detailed Answer:
Helo,
Thanks for query,

You are a known case of esophagitis.Bleeding in the upper digestive tract tends to cause black,Ulcers or another form of irritation in your esophagus or stomach known as gastritis can cause bleeding. When the blood mixes with digestive fluids, it takes on the appearance of tar.Green fuzz may be due to bile pigment in the stool if food moves too quickly thorough the intestine bile can't break down causing green tinge.

Advice
Go for stool test for occult blood to make sure if black color of stool is due to blood.
Please attach reports of your previous endoscopy.
How are your bowels due you feel constipated?
Please revert back for better advice.

Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ramesh Kumar 19 hours later
Hi Doctor! Thank you for getting back to me so quickly! Yes, constipated from time to time since last year, which is very strange. I am active but don't always eat right. I am also on Zyrtec (centrazimine) and pulmicort inhlaer 60 msg twice a day. I am leaning toward the Zyrtec perhaps, it drys the system out and one of side effects. Unfortunately I can not eat hard protein items without it, my esophagus will constrict if suffering from reaction to very bad environmental allergies. I see an allergist, allergy shots every week. The green color may be coming from new gnc women's vitamins, I saw what looked like green food coloring around stool today. Why would my esophagus bleed? I am pretty healthy for 52. I thought may be gall bladder..
doctor
Answered by Dr. Ramesh Kumar 4 hours later
Brief Answer:
Follow up suggestions.

Detailed Answer:
Hello again Dear,
Thanks for follow up query.

as per your query answers are-
See the role of parietal cells in our stomach is to secrete acid.This acid helps in digestion of food.The upper lining of stomach is naturally lined by layer of mucosa which can tolerate acid very well.However when this acid refluxes back from stomach to esophagus,It causes erosion and damage of the mucosal layer of esophagus(it is not designed to tolerate acid).This erosion and damage leads to severe inflammation. From this inflammed surface mild to moderate amount of blood can be lost which when comes in contact with digestive juices turns tarry black.
Right now you are on omeprazole(proton pump inhibitor) it inhibits secretion of acid in stomach however it has no effect on reflux of acid back in esophagus. I would suggest you to take a priokinetc drug along with omeprazole to prevent acid reflux(Domperidone 30 mg would be good for you).

Gall bladder most likely has nothing to with these problems.However green color can be due to it.Bile is produced by liver and is stored by gallbladder.When gallbladder is removed there is continuous seepage of bile from liver into gut.As the flow of bile increases its not properly digested hence giving green color to stools.

Hope i answered your query well dear patient.
Feel free to follow up.
Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ramesh Kumar 11 hours later
Hi Doctor,
Thank you. I have had "loose gas" and constipation from time to time. My endoscopy is 2 years old. What is best course of action, stool sample, endoscopy? Should my diet change? Again, since diagnosis of esophiliac esphogiatis diagnosis 2 years ago after endoscopy and medication feels like gastric system has not been the same. Yes, I do take a very good probiotic every night before bed. Just want to address before systons get worse. Again, I very much appreciate your recommendation of best course of action. I have been in and out of two GI offices regularly. Thank you!
doctor
Answered by Dr. Ramesh Kumar 50 minutes later
Brief Answer:
Best couise of action right now is follow all the advices for 4 weeks.

Detailed Answer:
Hello again Dear,
See in gut everything is linked to each other-
Say for example constipation is causing gas both are relate to each other .How? lets see-

The pathophysiology of gas and flatulence is complicated. Understanding gut microflora, gas production, intestinal transit, intestinal propulsion of gas, and sensory function within the GI tract are essential for understanding symptom generation.

The term gut microflora or microbiota means millions of species of bacteria which lives in our intestinal tractintestinal tract.These bacterias and yeast are responsible for proper digestion and fermentation of food. Hundereds of species of bacteria and yeast are found in colon of human intestine.In the same way thousands of these species florishes in our gut these bacteria play a vital role in digestuion and absorption of food.Even minor disturbances in gut microflora can lead to significant changes in gut function, including gas production.When a person is constipated the gut flora is disturbed grossly hence the food in gut is acted upon by bad bacteria's leading to incomplete fermentation causing release of gas and severe bloating.

If this microbiota is disturbed food is improperly fermented causing production of large amount of gases in gut leading to severe bloating.Hence most commmon cause in most of the cases is disturbed microbiota.In old patient mobility of intestines is severly compromised leading to accumulation of large amount of gases in intestines.As persitaltic moments are week gas accumulates in intestines.Severe constipation or incomplete evacuation can also hinder the passage of gases.

Recommendations-
Treat constipation and gas problem would solve by itself.
-Triphala: This combination of three fruits ensures that your digestive system remains in good working condition.
-Turmeric: Haldi or turmeric helps in reducing bloating and is one of the most commonly used spices found in ayurveda.
-Aloe vera: An ounce of aloe vera a day will keep indigestion away. Break off, a leaf and scoop some gel into a smoothie for smooth digestion.
-Drink plenty of water at least 8 glasses every day.Water is a lubricant and help in smooth passage of stools and prevent it from hardening.
-Take Metamucil 2tsf twice daily with half cup of XXXXXXX warm water.ITs a husk which absorbs water swells up and increases volume and bulk of stools.
-Avoid-
Dairy products, which contain sugar lactose that causes gas.
Vegetables, including onions, radishes, cabbage, celery, carrots, brussel sprouts, broccoli, cauliflower, and legumes.
Fruit sugar, which is especially high in prunes, raisins, bananas, apples, apricots and fruit juices from prunes, and apples
Fatty foods and carbonated drinks.

Eating more fermented foods. These are rich in both good bacteria and enzymes you can try raw natto kefir or cultured veggies. This is probably one of the most important first steps.
Taking a high-quality probiotic VSL#3 twice daily.
Exercising, to help keep food moving through your system.
Using spices that may help to prevent flatulence. These include turmeric, coriander, peppermint, fennel, sage, chamomile, and ginger.
-Use fish oil and castor oil-Fish oil is believed to encourage healthy digestion and castor oil produces a laxative effect when ingested.
-Pears are beneficial in the treatment of constipation.
Guava fruit when eaten with seeds, gives roughage to the diet and helps in the normal evacuation of the bowels.
Grapes: have also proved highly beneficial in overcoming constipation. The grapes have the cellulose; natural sugar and organic acid make them a natural laxative fruit. Not only they clean the bowel, but also tones up the stomach and intestines to relieve the chronic constipation.

If not relieved even after this we would again proceed with endoscopy and other basic tests of Gastroenterology.

Please feel free to clear any other doubt.

Thanks you.
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2435 Questions

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