Stool Coloration: How Do We Know What’s Normal?

I got an e-mail from a viewer of J-pouch.net and she was contacting me on behalf of her boyfriend, who is post-surgery. She was concerned because she said his stools were a reddish color, and he wasn’t thinking this was anything abnormal, but she wanted my opinion on whether this was something to look into.

In my response, I asked her what type of surgery he had, how long ago, and to clarify the reddish color. These can all be important in determining where the color might be coming from, and whether or not it’s normal.

From what I’ve previously looked into, it seems that darker reddish or black stools can indicate a problem in the upper part of the digestive tract, while brighter reddish stools can indicate a problem in the lower part. It could be as simple as something like an anal fissure or hemorrhoids, but it could also be more serious signs of something like colon cancer, or a digestive disease.

Seeing as we all have lived with a digestive disease, how can we differentiate what’s normal to be in a stool? First off, I need to say that you should ALWAYS ask your doctor first and take his/her advice. There is too much information on the internet and some of it might be false, or lead you into thinking the wrong thing, therefore causing some much unwanted stress. I can’t even assure that this information is correct, this is just what I’ve seen many times before from different resources.

I know I’ve seen a vast amount of colors in my own bowel movements, and I can usually always attribute it to something I’ve eaten. Since we are missing our large intestines, our food obviously isn’t totally digested by the time we excrete it. This would mean that any food with certain colors can also come out those similar colors. I know red gatorade, beets, Kool-Aid, or tomato juice can all cause a red color. When I take a multi-vitamin with iron, I notice my stool is is a lot darker than normal, and I know it’s because of the iron.

People like me, who have an ileo-rectal anastomosis, still have their rectum intact. There are chances that one could still get minor colitis in the rectum, and this could be a source of a reddish stool if that’s the case. For those living with the J-pouch, a reddish stool might be a sign of pouchitis, an infection that can be cured by a treatment of antibiotics. For anyone else, you might want to consult your doctor so you can get an answer as to what might cause the coloration.

As for us gay men, if you partake in receptive anal sex, it could be damage from sexual contact. For those living with the J-pouch, anal sex is not recommended at all, and I can imagine it would definitely lead to some bleeding. This is a very tender area and something you would definitely want to take care of.

Does anyone else see similar colors? And if so, what have you heard about the causes of this?