From the Guidelines
Carafate (sucralfate) is unlikely to cause melena (dark stools) as it forms a protective coating over ulcers and irritated tissues in the stomach and intestines, and its active ingredient may actually cause pale or clay-colored stools in some patients. The provided evidence does not directly support the notion that Carafate causes dark stools. In fact, the medication is used to protect the stomach and intestinal lining, which could potentially reduce the risk of gastrointestinal bleeding that often causes melena 1. Some key points to consider:
- Carafate contains sucralfate, a basic aluminum salt of sucrose octasulfate, which forms an ulcer-adherent complex at duodenal ulcer sites, protecting the ulcer and promoting healing 1.
- The medication is not typically associated with causing dark or black stools, which are more commonly linked to medications containing iron, bismuth, or bleeding in the upper gastrointestinal tract.
- If a patient taking Carafate experiences persistently dark stools, they should consult their healthcare provider to rule out other potential causes, such as gastrointestinal bleeding, especially if accompanied by abdominal pain, vomiting, or weakness.
- The use of sucralfate enemas has been studied in the context of radiation proctitis, where it is thought to stimulate epithelial healing and form a protective barrier, but this is a different formulation and use case than oral Carafate 1. It is essential to report any unusual stool changes to a doctor to determine if they are medication-related or require further investigation.