Definition
The feces are called picee when they appear blackish, greasy, with a similar appearance to tar (particularly dark color and sticky consistency).
The adjective picee derives from the similarity with pitch, a highly viscous liquid of black color obtained from the distillation of bitumen or coal tar.
The picee feces are a typical sign of digestive hemorrhage, in particular of melena .
The term melena indicates the emission of faeces containing digested blood .
To have a visible melena with picee feces an important hemorrhage is needed, in the order of at least 80-100 cc (80-100ml) of blood.
The piceo color is due to the digestion of hemoglobin in soured ematin, mainly due to the effect of hydrochloric acid. Therefore, picee feces are a common sign of hemorrhages of the upper gastrointestinal tract, in particular those of the esophagus, stomach and duodenum.
Piceous feces may also be present in the case of bleeding of the lower intestinal tracts, provided that these are sufficiently slow to allow the digestion of blood by the local bacterial flora. According to a rough estimate, it takes about 14 hours for the blood to be digested by enzymes in the intestinal lumen.
The stools can continue to present picee for 48-72 hours after the bleeding ends.
The intake of supplements containing iron, black pudding or special drugs (aluminum hydroxide / magnesium hydroxide, bismuth subsalicylate) can cause the faeces to have a blackish color ( false picee feces ). Gastrolesive drugs (salicylates, corticosteroids, phenylbutazone, indomethacin, reserpine, etc.) are instead potentially responsible for true picee stools.
Possible Causes * of picee Feces
- Esophageal diverticula
- Hiatal hernia
- Esophagitis
- Barrett's Esophagus
- Marburg hemorrhagic fever
- Gastritis
- Gastroesophageal reflux
- Mallory-Weiss syndrome
- Stomach cancer
- Esophagus tumor
- Duodenal ulcer
- Gastric ulcer
- Peptic ulcer
- Esophageal varices
