The Color of Stool

Friends of mine told me they were concerned that their four-year-old son’s stools had taken on a dark purple color. They had already made an appointment with the pediatrician when they figured out the problem -– the kid had found their secret stash of grape-flavored fruit-roll-ups! Many people who suffer from irritable bowel syndrome (IBS) become concerned about the various shapes, colors and sizes that they see in their bowel movements. As you can see by the preschooler’s tale, stools can change dramatically without necessarily signaling serious illness. When you are feeling quite ill from your IBS, it can be hard to know when to worry and when to breathe easily.

Hypervigilance

The psychology of IBS can be similar to that of post-traumatic stress disorder. When you have been traumatized by severe symptoms, your brain automatically wants to search for signs related to your disorder. This can result in hypervigilance -- a constant state of anxious watching and worrying. The catch-22 problem with IBS is that this anxious state can trigger or exacerbate the very symptoms that you are worried about. Thus, it is important for you to to reduce your anxiety whenever you can. One way to do this is to reduce your focus on the way that your stool looks.

Check Weekly, Not Daily

A person who suffers from an eating disorder will cause himself unnecessary anguish by checking the scale constantly. If the numbers are up, he becomes upset. The problem is that scales are not precise instruments and fluctuations in scale measurements are not necessarily indicative of weight gain. This same principle can be applied to daily examination of your bowel movements. In both cases, a better strategy would be a weekly checking. That way, you can be confident that you are monitoring your health, but not exposing yourself to unnecessary emotional distress.

IBS and Stool Changes

By definition, IBS involves a change in stool appearance. So, yes, your stool may look abnormal to you. Just remember that abnormal does not necessarily mean that your doctors have missed a more serious disease. Typical IBS stools can be:

• A variety of colors, including dark brown, light brown, yellow, tan and orange
• Filled with mucous
• Thin and pencil-like
• Hard, lumpy and difficult to pass
• Soft, loose and watery

Red-flag Symptoms

You may have heard that red- or black-colored stools suggest bleeding and therefore could indicate colon cancer. While it is true that blood in bowel movements is a sign of colon cancer, there are many other not-so-scary possibilities, such as acute infection, a tear in the tissue of the anus, hemorrhoids, or non-cancerous polyps. In any case, the following colors are not typical of IBS and should immediately be brought to the attention of your physician:

• Bright red
• Dark red
• Black or tar-colored

_Sources:

Longstreth, G., Thompson, W., Chey, W., Houghton, L., Mearin, F. & Spiller, R. “ Functional Bowel Disorders. Gastroenterology 2006 130:1480-1491.

Thompson, W. “Alarm Symptoms: A Cause for Alarm?” International Foundation for Functional Gastrointestinal Disorders Fact Sheet.

Find a Gastroenterologist