Yes, I am back on Lactnet after my summer hiatus.

        In my many years of phototherapy experience, including participation
in the large NIH Phototherapy Study some years ago, I have never heard of or
encountered "black stools" as a result of phototherapy.  Bilirubin excretion
into stool is increased as a result of phototherapy, but bilirubin is yellow
and does not convert to a black pigment in the GI tract. In older children
and adults, bacteria in the intestine convert bilirubin into stercobilin,
the brown pigment which is the color of normal stool.

        I am both concerned and surprised to hear of black stools after
phototherapy and particularly concerned that it has been seen twice in one
person's recent experience.  Furthermore, it is of special concern that the
home phototherapy nurse "said to expect black stools."  This suggests that
she is seeing this as a regular occurrence.  Please tell us more about the
type of phototherapy unit that is being used in each of these cases.  Also,
are the infants being given any medications or any other treatments at the
same time or just before the initiation of phototherapy?  Since black stools
of the type you describe when seen after the passage of meconium are often
due to GI bleeding, is there any evidence that these infants are bleeding?
Was this investigated?  Certain drugs also cause black stools.  More info,
please.
                                                Larry Gartner
Lawrence M. Gartner, M.D.
Professor of Pediatrics and OBstetrics/Gynecology
The University of Chicago
MC6060
5841 S. Maryland Avenue
Chicago, IL 60637
Phone: (312) 702-0389
FAX: (312) 702-0764
E-Mail: [log in to unmask]