Alzheimer’s meds might cause a dark discoloration in stools

My wife is 78 and has had Alzheimer’s disease since 2011. Her meds are 5 mg of escitalopram daily, 10 mg of memantine daily, and 25 mg of quetiapine daily. Could this be the reason she has had almost black bowel movements for the past five months?

She doesn’t have control over her bladder or bowel. Her diet has not changed. -- J.T.

ANSWER: Several medications can turn stools a dark or black color. Iron is common, and there are a handful of others, but the most common is the overthe-counter medicine Pepto-Bismol, or any other brand of bismuth subsalicylate. This reliably turns the stool a dark, tarry color, which often concerns my patients. This is because dark or black stools are very concerning for blood in the bowel movement, which could signify polyp or colon cancer.

I do understand your wife has been unwell for years, but she should still have an evaluation for any cause of blood in the stool. Once you identify what the problem might be, you can make the best decision of how to treat it. Black stools require timely attention.

DEAR DR. ROACH: I am soonturning 75, and since my teenage years, my morning routine has been the same: a hot shower after getting out of bed, including washing my hair with shampoo. I have a full head of hair, and over the years, I am often complimented on my thick, but soft hair. However, for the past year, my hair is no longer easy to brush. After showers now, it is difficult to get a brush through my hair. The hair feels stiff and tangled.

Is this recent annoyance a function of aging, or could it be some chemical change? I am using the same shampoo I’ve always used, and I have confirmed that our water softener is working properly. I know this is a weird question, but I’m really wondering if this is just a function of aging. -- K.H.

ANSWER: It’s not a weird question at all. Both men and women are very concerned about any change in their hair. Hair is very important to how we look and feel about ourselves in many ways. Hair can also be a clue to medical changes within our bodies.

I often see both men and women have changes in their hair with aging. In both cases, hair loss can be a problem. Many also note diffuse thinning of their hair. But your concern about stiff, tangled hair is one I haven’t heard before.

As an internist, I’d be concerned about a low thyroid gland level -- a simple blood test can diagnose that. Thyroid diseases often cause different types of hair changes. If that isn’t the cause, then I’d recommend a visit with a dermatologist, who is the expert not only on skin problems, but also on changes in nails and hair.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.