Abdominal pain and stool color

[Furtie]

I have had a return of symptoms that I first suffered two years ago - mild discomfort in mid-upper abdomen often going through to the back and clay-colored stools. Last time I had an endoscopy and CT scan which showed nothing and the symptoms went away. In December last they came back, my doctor first said ulcer and I have been taking Zoton but don't think they make a difference. I am pretty healthy (vegetarian) and active. Last week I went for a cycle training ride after which I had a beer with my club. I felt fine but next morning immediately I went to the toilet I produced about 8 balls of stool which were black in color. Next day I had a normal large stool which was dark brown. Now my stools are back to being large and soft, some of them float and are of a clay color. I still have the abdominal discomfort. I feel ok, no weight loss though I did feel tired last week. I notice that the edges of my ribs are sore and when I am in bed it can be uncomfortable if I am tipped forward so that my stomach kind of hangs towards the front. Could the exercise have made my symptoms worse? Could it be back pain related? What should I ask my doctor to think about? I am female, 50 and about 140 pounds. My father died of lung cancer aged 50 so this is unwelcome and I guess I am worrying about cancer.

[Kevin Pho, MD]

Clay colored stools are associated with biliary duct obstruction.  Any type of gallbladder disease can cause this and I would suggest further evaluation.

The first test to consider would be an abdominal ultrasound and liver function tests.  If there are suspicious or inconclusive results, you may want to consider an ERCP or MRCP, which would be the most comprehensive test we have to evaluate the biliary tree.  

To answer your questions:
1) Exercise may make the symptoms worse, however I would ensure there is no gallbladder cause first.

2) Again, it may be - but with the clay colored stools, I would exclude the gallbladder.

3) I would suggest an abdominal ultrasound and liver function tests as initial studies.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[Nina56]

A related discussion, What do I have to eat to stay regular? was started.