Black Bowel Movement

One thing you may notice with your stomach cancer is a black bowel movement. These are experienced because of bleeding, from the tumor or another source.

The change in color is due to changes in the bloods haemoglobin which normally carries oxygen in your blood. These changes occur as blood passes through the small intestine.

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Bleeding From Your Tumor

Malignant tumors have blood vessels within them and can ulcerate and bleed. The tissues is quite ‘friable’ (this means the tissue is very soft and easily damaged, inducing bleeding). The amount of bleeding can vary from very mild to severe.

Clotting Issues

If you cut yourself, you normally bleed, but this stops spontaneously because of your bodies clotting mechanisms. Platelet cells that normally stop you bleeding can be reduced in numbers when you have stomach cancer and can be from the direct effects of your cancer on the bone marrow which produces these cells. It can also occur because of the chemotherapy treatment you've received killing off the cell production as chemo drugs don't differentiate between good cells and cancer cells.

Clotting factors produced in your liver can be reduced if you have tumor deposits in your liver. Also, with any malnutrition, vitamin K (a clotting dependant factor) may be reduced (it is a fat soluble vitamin so if your not eating well, the amount of fat intake may be low).

From Other Causes

There are many other sources of bleeding other than from your tumor. I have listed some of these below for you:

  • Peptic Ulcer Disease (Stomach and Duodenal)
  • Esophagitis
  • Esophageal ulcer
  • Mallory-Weiss Tear - a tear in the esophagus from retching
  • GAVE (Gastric Antral Vascular Ectasia) - Abnormal blood vessels in your stomach lining. Sometimes referred to as 'Watermelon stomach'
  • Angiodysplasia - Abnormal blood vessels near the surface of the gut lining
  • Hematobilia - Bleeding through the bile duct

Plus many more!

Black Bowel Movement On Iron

If you're taking iron, you will develop black bowel movements. The iron is converted by your stomach acid which in turn makes the stools black. Iron not only makes your stools black, but can also make you constipated and bloated.

Investigation of Bleeding

If you're having a lot of problems, you may need to have the bleeding investigated with an endoscopy test. Take a look in the diagnosis section (click on the about section in the site navigation) to learn more abou this. There are a variety of endoscopic treatments to stop bleeding and I have listed some of these below for you.

Treatment Of Bleeding

Tumor bleeds are quite difficult to stop, but sometimes the surface can be sprayed with adrenaline (which makes the blood vessels close). Hemospray can be used to stop the bleeding (this is a powder that is sprayed over the bleeding area and causes the coagulation to occur). There's also a glue that can be used to help stop it. All these methods are delivered endoscopically.

Your stomach cancer can sometimes be cauterised or ‘burnt’ to help stop the flow of blood. This can be a tricky method as cauterisation can sometimes actually induce bleeding. This method has to be carried out by a skilled endoscopis. 

If there is a blood vessel evident, the endoscopist can put an endoclip on it to stop the bleeding. These are clips that are passed through the endoscope and can be opened then closed over the vessel. The clip is then released or deployed ('fired') hopefully with success. It will eventually 'fall off' when healing has occurred.

If there is no endoscopic means to stop the blood, clips can be placed either side of the tumor which will show up on x-ray. This will allow you oncologist to possibly treat you some radiotherapy to stop the hemorrhaging.

If all else fails, an operation may need to be performed if appropriate.

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