Green Stool : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 12/08/2022

Green stool is the acquisition of various greenish hues by stools. The symptom is often accompanied by diarrhea, flatulence, and abdominal pain. The appearance of a green color of feces is observed with the use of certain foods and drugs, dysbacteriosis, intestinal infections, and chronic pathology of the gastrointestinal tract. Examination of the patient involves a coprogram, ultrasound examination of the abdominal organs, radiography and endoscopy. To normalize the color of feces, a diet, sorbents, probiotics, and enzyme preparations are prescribed.

Causes of green stool

Food habits

The use of a large amount of green leafy crops (spinach, dill) and vegetables leads to characteristic changes in the color of feces due to the excess content of the pigment chlorophyll. At the same time, the feces are formed, do not have a putrefactive odor, the frequency of defecation does not change. The dark greenish color of the stool is caused by the use of black licorice, caramel and marmalade with dyes. Stool color returns to normal in 2-3 days.

Dysbacteriosis

The accumulation of pathogenic microorganisms in the intestine provokes the processes of decay, while the formation of specific protein compounds occurs, which cause the discharge of green feces, which has a sharp fetid odor. Fecal masses in dysbacteriosis are unformed, soft, sometimes liquid. The color ranges from greenish yellow to dark green. Sometimes a light green coating forms on the surface of the feces.

The allocation of a chair of an atypical greenish color is combined with discomfort and rumbling in the abdomen, flatulence, pain and spasms. During defecation, patients notice a sharp pain along the intestines, especially in the left sections. The changed color of feces persists for a long time, until the cause of dysbacteriosis is eliminated. Such a clinical picture is an indication for visiting a doctor.

 

Intestinal infections

The entry of pathogens into the intestines and their reproduction are the main causes of the appearance of green feces in adults and children. The symptom is pathognomonic for salmonellosis. This intestinal infection is characterized by liquid, foamy, dark green stools of a heterogeneous consistency. Feces have a strong putrid odor, the frequency of defecation increases from 5 to 15 times a day, depending on the severity of the disorder.

The greenish color of feces is also typical for viral infections - rotavirus enteritis, enteroviral gastroenteritis. First, green diarrhea is observed, then the stools lose their fecal consistency - in case of severe intestinal damage, a greenish liquid with an unpleasant odor may be released during defecation. The symptom is accompanied by nausea, vomiting, diffuse abdominal pain, lack of appetite.

Chronic diseases of the gastrointestinal tract

A change in the color of feces is most common in chronic enteritis, which is characterized by a deterioration in abdominal digestion, fermentation and rotting of food in the intestine. Putrefactive reactions cause the formation of pathological chemical compounds that color the stool green. Diarrhea is noted, fecal masses are plentiful, fetid, sometimes acquire an "oily" appearance. The main reasons for the release of green feces:

  • Diseases of the stomach : hyperacid gastritis, peptic ulcer, functional dyspepsia.
  • Inflammation of the intestine : ulcerative colitis, enterocolitis, Crohn's disease.

Allergy

For people prone to allergic reactions, the development of dyspeptic symptoms after eating exotic foods and allergenic foods is pathognomonic. With food allergies, diarrhea begins, the rhythm of bile secretion into the intestine is disturbed, which causes the presence of a greenish color of feces. The duration of unpleasant symptoms is 3-5 days, after which the condition improves, the color of the feces returns to normal.

Damage to the hepatobiliary system

The usual brown color of feces is due to the presence of bile pigments, which undergo chemical transformations in the intestine. If the color of the feces changed to green, and heaviness and dull pain appeared in the right hypochondrium, it means that the color changes caused causes from the gallbladder and liver. Usually the feces are soft, unformed, light green or yellowish in color.

With an exacerbation of the disease, the color of the stool changes to grayish-white. Also, a person is worried about constant nausea and periodic vomiting with bile impurities. The duration of fecal color change ranges from several days with biliary dyskinesia to several weeks and even months with cholecystitis and cholangitis. With hepatitis, there are greenish stools, but lightening of the feces is more characteristic.

celiac disease

Symptoms are often detected in childhood. There is prolonged diarrhea for no apparent reason. Due to violations of the digestion of food in the small intestine, the feces become green, the stools are liquid, plentiful, fetid. Patients with celiac disease complain of constant abdominal pain, weight loss, and sometimes vomiting. Diarrhea can be replaced by constipation, when the stool becomes dark, almost black. The patient's condition is progressively deteriorating.

Complications of pharmacotherapy

There are a number of drugs that can change the color of feces. Most often, the symptom manifests itself in the treatment of anemia with iron preparations. The microelement is excreted with feces, which is characterized by a dark green or black color. The symptom persists throughout the period of iron intake. Green feces in an adult are also caused by other medical reasons: treatment with laxatives, iodine preparations, multivitamin complexes.

Rare Causes

  • Chronic bleeding from the gastrointestinal tract .
  • Tumors of the stomach and intestines .
  • Congenital pathologies : disaccharidase deficiency, intestinal form of cystic fibrosis.
  • Endocrine diseases : diabetes mellitus, thyrotoxicosis, Itsenko-Cushing's disease.

1 - Meconium. 2 - Feces with alimentary dyspepsia. 3 - Feces of a child fed on cow's milk

 

Diagnostics

If green stool appears, you should consult a gastroenterologist. The plan of diagnostic measures includes advanced laboratory tests and modern methods of visualization of the digestive system. If necessary, the patient is referred for consultations to related specialists. The most informative are:

  • Coprogram . When examining green stool under a microscope, it contains a large number of undigested food particles, an increased content of erythrocytes and leukocytes, which indicates inflammatory processes in the intestine. With possible intestinal bleeding, the Gregersen reaction is performed occult blood. Analysis of fecal elastase allows to exclude pancreatitis.
  • Bacteriological Research . When changing the color of feces, a microscopic analysis is always carried out for helminth eggs. Be sure to inoculate feces on selective nutrient media to detect typical pathogens of the intestinal group: Salmonella, Escherichia, Shigella. In case of difficulties in diagnosis, blood ELISA is prescribed to detect antibodies.
  • Ultrasound . In an adult, the appearance of green feces is often caused by somatic causes, which require ultrasound of the abdominal organs to confirm. Sonography allows to exclude space-occupying formations and other severe lesions of the intestine. Targeted ultrasound of the liver and gallbladder is necessary for the diagnosis of cholecystitis, hepatitis.
  • Radiography . Irrigoscopy with double contrast helps to assess the structure of the colon and identify areas of mucosal destruction, deep ulcers or diverticula. Barium passage X-ray is an effective method that can be used to assess the condition of all parts of the gastrointestinal tract, to detect signs of peptic ulcer.
  • Additional methods. FGDS is recommended for signs of gastroduodenal pathology. In patients with suspected inflammatory bowel disease, a colonoscopy with biopsy is indicated. To make a diagnosis of celiac disease, a cytomorphological study of biopsy specimens of the small intestine is performed, specific antibodies are determined. To find out the cause of severe allergies, an immunogram is informative.

Treatment

Help before diagnosis

The greenish color of stools associated with the use of certain foods does not require specific therapy. It is enough to exclude provoking factors from your diet, and after a couple of days the color of the stool returns to normal. If the symptom is accompanied by nausea, diarrhea, abdominal pain, you should consult a doctor to find out why the feces turned green. The presence of streaks of blood in the feces is an indication for emergency hospitalization.

Conservative therapy

An important component of treatment is a special diet. In the acute period of intestinal infections, other gastrointestinal pathologies, a person is transferred to a sparing diet - mucous soups, pureed cereals on the water. After the normalization of the stool, the patient gradually returns to the usual diet. Celiac disease is treated with a lifelong gluten-free diet. Medications are selected depending on the cause of green feces. For therapeutic purposes, use:

  • Sorbents . They are prescribed for all cases of greenish stools and diarrhea, as they effectively remove toxic metabolic products and bacterial agents from the body. Darkening of the feces against the background of the use of activated charcoal preparations is a variant of the norm.
  • Probiotics . In dysbacteriosis, during the recovery period after intestinal infections, probiotics are necessary to colonize the colon with beneficial lactobacilli. The drugs improve motility, eliminate abdominal discomfort, help normalize the frequency and consistency of the stool.
  • Antisecretory agents . In hyperacid conditions, medications are effective that reduce acidity in the stomach, prevent the development of ulcers and bleeding from the gastrointestinal tract. Preference is given to protein pump inhibitors, characterized by long-term action and minimal side effects.
  • Enzymes . With the gastrointestinal form of intestinal infections and chronic enteritis, pancreatin and dry bile have a good therapeutic effect. Enzyme replacement therapy stimulates digestion and eliminates malabsorption syndrome, due to which all dyspeptic disorders disappear.
  • Antibiotics . Antimicrobial agents are indicated in severe generalized bacterial diseases to address the infectious causes of the disorder. Predominantly use drugs from the group of fluoroquinolones, tetracyclines. Sometimes therapy is supplemented with sulfonamides. In viral infections, etiotropic drugs are not prescribed.

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