Your stool is a combination of water, undigested food material (mostly fiber), mucus, and bacteria. Commonly, stool is brown in color due to the presence of bile that the intestinal bacteria break down. However, there are times when your stool may change in color.
Because stool is largely the result of what foods you eat, black specks in stool are commonly a result of your diet. Some exceptions exist, though. Black specks or flecks can be old blood present in the gastrointestinal (GI) tract.
Because blood in the stool can be a medical emergency, it’s important to understand when to worry about black specks in stool.
The presence of black specks in stool or when wiping is usually due to one of two causes: something you ate or bleeding in the GI tract.
Food- or medication-related causes
The body may not completely digest some foods, which can result in black specks in the stool. Examples of foods that can cause black specks include:
- foods that use food coloring to darken them, such as chocolate puddings or licorice candies
- herbs and spices, such as black pepper or paprika
- red meat, especially undercooked meat
- undigested seeds, such as strawberry seeds or sesame seeds
Foods that are rich in iron can also cause black-tinged stool. This can sometimes present as flecks or specks as well. Examples of these foods include oysters and kidney beans. Taking iron supplements can also cause stool to turn black or green with black specks.
More serious causes
Other times, the cause of black specks in the stool is due to something more serious. This is the case when black specks are caused by bleeding in the GI tract or a parasitic infection.
Sometimes these specks are described as having a “coffee grounds” appearance. As a general rule, the longer blood travels in the GI tract, the darker it tends to be in the stool. This is why doctors consider bright red blood in the stool as lower GI tract bleeding, while darker blood is usually due to upper GI tract bleeding. Inflammation, a tear, or even a cancerous lesion can cause bleeding to occur in the upper GI tract.
Sometimes taking certain medications known as nonsteroidal anti-inflammatory drugs (NSAIDs) can cause irritation and bleeding that leads to black specks in the stool. Examples of these drugs include ibuprofen.
Parasites are a type of organism that use another organism as a host. They can be spread through contaminated water, food, soil, waste, and blood. The black specks in your stool can be caused by the eggs or waste of the parasite.
In babies, the first few stools passed are almost pure black. These are known as meconium stools. They occur because the stools were created in the womb when bacteria that colonize in stool weren’t yet present. Some of the meconium may remain in the stool, which can appear like black specks.
However, in older children, black specks in stool are either due to the causes listed above or after ingesting something that may flake off as black, such as pieces of paper.
The treatments for black specks in stool often depend upon the underlying cause. If you can recall your diet over the past 48 hours and identify a food that could present as black specks, stop eating that food to see if the black specks go away.
If you take medications known to cause an upset GI or GI bleeding, contact your doctor to determine if you can safely quit taking the medication to reduce GI irritation.
Black specks in stool due to gastrointestinal bleeding require a doctor’s attention. Your doctor will review your medical history and symptoms. They may order laboratory testing, such as a complete blood count to see if you have lower-than-normal blood counts. Low results could be a sign that you’re experiencing GI bleeding.
Your doctor may request a stool sample and send it to a laboratory to test for the presence of blood. They may also do a test in the office to check your stool for blood using a hemoccult card. If blood is detected in your stool, they may recommend a procedure known as a colonoscopy or an esophagogastroduodenoscopy (EGD).
An EGD involves using a special instrument with a thin, lighted camera on the end inserted into the mouth to view the upper GI tract. A colonoscopy involves inserting a similar scope in the rectum. This allows your doctor to visualize all parts of the colon and identify areas of bleeding.
If your doctor identifies an area of bleeding, they may use special tools to cauterize or burn the bleeding area so it’ll no longer bleed. If findings are consistent with inflammatory bowel disease (IBD), your doctor will make treatment recommendations. Examples of IBD include:
If your doctor suspects a parasitic infection, they may order a blood test or a stool test. Parasites can usually be treated with medications.
If you see black specks in your stool, think about what foods you ate in the past 24 to 48 hours that could’ve caused them. If you stop eating that food and your next stools are free of the black specks, the food was likely to blame.
If you experience black specks in your stool and have some of the following symptoms, make an appointment with your doctor:
- lightheadedness or dizziness
- low blood pressure
- rapid heart rate
- upset stomach, greasy stools, and stomach pain that lasts longer than three days
The earlier your doctor diagnoses and treats GI bleeding, the less likely it is to cause severe symptoms.