What’s Wrong with Chocolate Cake for Breakfast?

Here’s what to say to critics about eating chocolate cake for breakfast.

Not too long ago I was at the Cheesecake Factory with family. Now, anyone who’s familiar with the Cheesecake Factory knows that they have killer chocolate layer cake.


I knew I wouldn’t have much room for it after eating my huge appetizer of nachos, followed by pizza and pasta.

But others had ordered their dessert to eat right then and there, and asked me why I was ordering the chocolate cake to go (I guess they were surprised I didn’t have the room for it).

I said, “I’m going to eat it for breakfast, when I’ll be good and hungry for it.”

“Chocolate cake…for BREAKFAST?”

“Yes, why not?”

I then explained the following, which is what you should tell anyone who questions your decision to eat chocolate cake for breakfast:

People eat a stack of pancakes smothered in syrup and butter for breakfast all the time. This has as much white flour, sugar and fat as any serving of chocolate layer cake.

I bet you’ve had French toast for breakfast. That, too, is loaded with calories, sugar, white flour, and with butter, there’s fat – and no less of these than in a serving of chocolate layer cake. And need I point out the Belgian waffle, especially if slathered in sugary jam or syrup?

And what about donuts and especially eclairs for breakfast? People eat all sorts of pastries for breakfast, like giant cinnamon rolls, bear claws and sticky buns—all the sugar and fat of a piece of chocolate layer cake.

Yes, think about it: Who says you CAN’T have a chocolate confection for breakfast? Just make sure you have a tall glass of very cold milk to go with it!

Spicy Food & Lipitor Will NOT Cause Bloody Stools

Many people wonder if spicy food or Lipitor will cause blood in the stools.

So I posed this question to Franjo Vladic M.D., a board certified gastroenterologist with Center for Digestive Health and Endoscopy Center in Ohio.

Dr. Vladic explains, “Lipitor is a cholesterol medication known as a statin. Statin medications will not affect the gastrointestinal tract, but rather, can potentially cause non-life threatening abnormal liver enzymes elevations. It does not affect the GI tract directly.”

And hence, Lipitor will not cause blood to be in your stools. If you notice this finding in the toilet bowl, do not assume it’s being caused by the statin.

What about spicy foods causing blood in your poops?

Dr. Vladic says, “Spicy foods do not cause any damage to stools. The concerns with spicy foods is with gastroesophageal reflux disease (GERD). Individuals with GERD can exacerbate of symptoms with spicy foods. Bloody stools are not a symptom of eating spicy food.”

What about turmeric?

Turmeric is also known as curcumin, and is one of the most powerful antioxidants known to science. In powder form, it’s an intense dark orange.

“If you look at the side effect profile of turmeric, the FDA has not reported evidence of associated bloody stools thus far,” says Dr. Vladic. However, in supplement form, tiny particles can end up mixed in your feces, creating a slightly orange tinge. These are undigested particles of this health-giving spice, which is commonly eaten in India—where the incidence of Alzheimer’s disease is strikingly low.

Is Ensure the Cure for Poor Appetite?

Why Ensure is not the magic bullet for sick people suffering from appetite loss.

If ONE more health professional asks me if I’ve tried Ensure with my mother, I will (fill in the blank)…

Yes, it was really beginning to anger me when a medical professional, hearing about my elderly mother’s appetite loss for the first time, asked me if I had tried Ensure with her. In fact, this became predictable.

The second the words came out, “Have you tried…”

I’d cut in with, “Yes, yes, and it doesn’t restore her appetite…”


I’d think, Heaven, please help me.

My mother struggled with appetite loss about three weeks after hip replacement surgery following a fracture. This situation had me deeply worried, because a 116 pound, 5-4 elderly woman cannot afford to lose more weight when she has very low muscle mass.

Getting her to eat was a battle. Not only did she claim that eating made her vomit, I actually witnessed upchucking episodes. My elderly mother had developed an aversion to food, not just some mere “I’m not very hungry” feeling.

“Get that away from me!” she’s snarl when we offered her eggs, rice, fish—foods she’d normally eat. She was growing weaker, withering away.

And yes, I tried Ensure. What the health professionals failed to realize is that all the added vitamins, minerals, protein and fiber in a bottle of Ensure are worthless if the patient refuses to ingest anything edible!

If someone refuses to eat or drink calories, then they’re refusing, period. Hovering a glass filled with Ensure before them won’t change this! I couldn’t get my mother to drink a bottle of Ensure any more than I could get her to eat a bowl of mac ‘n cheese. I was lucky if she sipped three tablespoons’ worth.

She was eating barely enough for basic sustenance, and before this lack of eating became life-threatening, her appetite began returning—with the help of Effexor (which she had been off of since the surgery).

Bottom line: If some kind of physical and/or psychiatric pathology has made eating highly aversive to a patient, Ensure—which is essentially liquid chocolate-flavored candy with synthetic vitamins and minerals tossed in—isn’t going to cure that.

Pooping After Every Meal: Causes, Solutions

Sick of having to make a poop after every meal and wondering what’s causing this? There are actually multiple possible causes for having to make a bowel movement shortly after just about every meal.

“One of the things to worry about is insufficient enzyme production by the pancreas,” says Matilda N. Hagan, MD, an inflammatory bowel disease specialist at The Center for Inflammatory Bowel and Colorectal Diseases, a part of The Melissa L. Posner Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore. I interviewed her for this article.

“This can cause mal-digestion and malabsorption, leading to pooping after meals.” A condition called exocrine pancreatic insufficiency is when the pancreas doesn’t produce enough enzymes.

Causes of EPI
• Chronic pancreatitis (causes include heavy drinking, smoking, high triglycerides, lupus, Sjogren’s syndrome, type 1 diabetes, or blockages in the passageways from stones or tumors)
• Recent surgery on the pancreas, intestines or stomach

More Causes of Pooping After Most Meals
“Some people can have bile acid diarrhea which is worse if the gallbladder has been removed,” says Dr. Hagan. “In this case people may commonly poop after every meal especially if it is a greasy or fatty meal.

“For some, this may be how their system functions, and when it is their normal state, there usually is no abdominal pain or bloat related to this.”

Solutions to Having a Bowel Movement after Every Meal
Dr. Hagan says, “Depending on the cause, there are specific strategies from changes in diet to medications that should be discussed with a health care provider.”

A benign condition called microscopic colitis may make it seem that every meal sends you straight to the toilet. In the literal sense, this is not true, but if the diarrhea that’s associated with this condition is frequent enough, it may seem that you are having a bowel movement (albeit diarrhea) after every meal.

“Tarry Black” Stools Defined by GI Doctor

“Tarry black” stools defined by a doctor, NOT Yahoo Answers!

Once and for all, here is what tarry black stools look like:
“In the simplest sense, the stool has the look and consistency of tar used to pave the road,” says Matilda N. Hagan, MD, an inflammatory bowel disease specialist at The Center for Inflammatory Bowel and Colorectal Diseases, a part of The Melissa L. Posner Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore. I consulted her for this article.

Have you ever seen small chunks or clumps of moist, solid tar on a freshly paved road? It doesn’t go from a hot liquid to solid dry concrete in an instant.

Remnants of tar do make their way off the side of a road while it’s being paved, and if you’ve ever seen these clumps while they’re still somewhat wet, but not hardened and dried, you can almost imagine that stools might look something like this—if mixed with old blood from the upper colon.



Dr. Hagan explains, “This term [tarry stools] describes blood in the stool, especially blood that has been processed or digested from the upper intestinal tract. If you see black stool, you should consult a health care provider.”

Imagine taking a quarter cup of hot tar and mixing it with typical formed stools. What would you see? This is more like what tarry black stools would look like, versus tossing in clumps of moist, partially solidified road tar into an empty toilet and pretending that this matter is a collection of poops.

“Tarry stools”

But don’t get caught up with the exact definition of “tarry.” Black smeary stuff mixed with your BMs is an alarming sign—though this doesn’t always mean colon cancer. It can mean an ulcer or side effects from medications.

For more information on tarry or black stools, search this site in the upper right corner.

What “Diarrhea Alternating with Constipation” Really Means

Confused over what “diarrhea alternating with constipation” actually means? The commonly used phrase, diarrhea alternating with constipation, is sometimes seen in symptom lists for colon cancer and IBS, even ovarian cancer.

And it’s ambiguous. I asked for an elaboration from Matilda N. Hagan, MD, an inflammatory bowel disease specialist at The Center for Inflammatory Bowel and Colorectal Diseases, part of The Melissa L. Posner Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore.

Alternating Diarrhea and Constipation with IBS

Dr. Hagan explains, “Generally speaking, ‘diarrhea alternating with constipation’ is specific to ‘mixed type irritable bowel syndrome.’  This means a person has changes in their bowel habits such that at times they have diarrhea (well-known to be change in consistency of stool from formed to loose or liquid) or constipation where there is a decrease in frequency of bowel movement and/or passage of hard pellet-like stool.

“For some they may have normal formed stool in between or go from one extreme to the other.  As far as timing, skipping three or more days without a bowel movement counts as constipation, especially if it is associated with abdominal discomfort or bloat.”

Alternating Diarrhea and Constipation with Colon Cancer

You may have read that colon (or ovarian) cancer may cause “diarrhea alternating with constipation.” The aafp.org site states for colon cancer: “Constipation may be constant or may alternate with diarrhea.”

It’s that word “alternate” or “alternating” that throws things off. The aafp.org site states that in colon cancer, the “alternating constipation and diarrhea signify leakage of liquid stool” that’s “around the lower level of a tumor.” The cancer is “partially obstructing the bowel.”

What else can alternating diarrhea and constipation mean?

As Dr. Hagan explains, relative to IBS, it’s a time period of diarrhea, followed by a time period of constipation, and constipation is defined as three-plus days without a bowel movement and/or voiding hard, pellet stools.

Constipation can also mean straining hard to void hard stools, not necessarily pellet shaped; they can be larger chunks—but hard, necessitating a lot of straining and discomfort while you’re on the toilet seat. You may even be having normal frequency of BMs, but nearly every time, they are hard and require heavy straining.

What if in between these episodes, you have diarrhea? This would fall under the category of “alternating.” The in-between episodes themselves can vary.

For instance, Monday, Tuesday and Wednesday you have BMs—all hard and requiring straining. But Thursday you have diarrhea. Friday you strain and void hard poops. Saturday, diarrhea. Sunday, diarrhea. Monday, a few hard, straining bowel movements. Wednesday, diarrhea. You get the picture. Any given day is either all diarrhea or all constipation.

Another scenario is that on a given day, you have both diarrhea and constipation. The day after may be all diarrhea—or all constipation.

Or maybe in between normal voiding days (formed non-hard stools), you have days of both constipation and diarrhea. There are benign causes like IBS and food intake, but potential (less likely) serious causes like colon and ovarian cancer, and Crohn’s disease.

In short, the concept of diarrhea alternating with constipation comes with multiple permutations. No particular permutation points to colon or ovarian cancer! Dr. Hagan says, “If the symptoms are present for three months or longer,” you should “consider discussing with a health care professional.” However, if the symptoms come with other issues such as unexplained weight loss, pelvic or stomach pain, back or leg pain, poor appetite or new-onset fatigue, don’t wait longer than two weeks to make a medical appointment. If you see blood in your stools, make the soonest appointment.

Source: aafp.org/afp/2000/0315/p1759.html#sec-7

Gray Stools: Causes & Should You Worry?

Yes, you should worry if your stools are gray.

Gray stools are concerning. Sometimes when doctors talk about grey stools, they use the terms “clay colored”  or “pale.” However, “clay” can bring up images of bowel movements that are the color of the standard clay pot that people plant flowers in: a dull or salmon-like orange.

But the “gray” here is an actual greyish hue, like what would result if you mixed white paint with black.

Causes of Grey Stools

“A person’s usual stools in terms of color, shape and consistency are based on their diet,” begins Franjo Vladic M.D., a board certified gastroenterologist with Center for Digestive Health and Endoscopy Center in Ohio.

“However, if a person’s stools are clay colored or pale, health care providers will be concerned about the patient’s biliary system,” continues Dr. Vladic, whom I interviewed for this article. “This could be a sign of bile duct obstruction (gallstones, pancreatitis, inflammation of the liver or pancreatic cancer).

“Clay colored stools indicate the biliary system is not draining properly because of a blockage. If the system drains properly, stools will either present as shades of green to brown.”

Pancreatic Cancer

  • The American Cancer Society estimates that in 2016, about 53,070 people in the U.S. (27,670 men, 25,400 women) will be diagnosed with pancreatic cancer.
  • Risk factors that can be changed: tobacco use; obesity as well as being overweight primarily in the midsection though not very overweight elsewhere; exposure to dry cleaning and metal working chemicals; lack of exercise (according to some studies but not all).
  • Uncontrollable risk factors: age, being black (a mild risk that’s not understood), family history, genetic syndromes, diabetes (type II mainly), chronic pancreatitis, liver cirrhosis, pylori stomach infection.

“If the stools are not pale or clay colored, the color is affected by the patient’s diet.” Don’t be afraid to check your stool color every now and then; grey means you must see a doctor.

Source: cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-key-statistics

Can Accutane and Celebrex Cause Blood in Stools?

“Yes, Accutane has the potential to present as blood in stools,” says Franjo Vladic M.D., a board certified gastroenterologist with Center for Digestive Health and Endoscopy Center in Ohio, whom I consulted with for this article.

Accutane is a medication that’s prescribed for acne. It is so important to know what is a normal appearance and color of your bowel movements. Periodically check the toilet bowl; take a good look at your poops before flushing.

Dr. Vladic explains, “Accutane (isotretinoin) has the potential side effect of aggravating or triggering inflammatory bowel disease in susceptible individuals.  How it causes these colitis-type symptoms is not clear, but Accutane can cause ulceration and inflammation in the gut mucosa (lining of the gut).”

What about Celebrex causing blood in your BMs?

You’ve certainly seen all the commercials for Celebrex, a pain reliever. “Celebrex is a medication that can cause blood in stools, similar to aspirins or nonsteroidal anti-inflammatory medications by increasing the risk of ulcerations in the GI tract,” says Dr. Vladic. “This medication affects the GI tract directly.”

Flat Ribbon Stool Causes other than Colon Cancer

Are your stools coming out like flat ribbons and scaring the daylights out of you?

If so, you’ve no doubt read or heard that colon cancer can cause BMs to come out in the shape of flat ribbons. If this happens, what should you do?

When someone notices ribbon stools, “the medical provider is concerned about the possibility of colon obstruction or IBS,” says Franjo Vladic M.D., a board certified gastroenterologist with Center for Digestive Health and Endoscopy Center in Ohio. I consulted with him for this article.

Dr. Vladic continues, “If there is an obstruction, it’s because there is something in the lumen [lining] of the colon causing it to be thin (i.e., a large colon polyp, narrowing from stricture, or mass).”

Yes, a benign polyp can cause flat ribbon stools by partially blocking the anal exit that BMs would go through, causing the feces to take on this peculiar formation. A polyp has a good chance of evolving into colon cancer if not removed, so that’s why during a colonoscopy, any polyps that are discovered are removed on the spot.

A “mass” can be cancer in the colon—which would be discovered in a colonoscopy, removed and sent to a pathology lab for a biopsy.

“For IBS, stools can be flat, but providers are unaware as to what causes the stool to present this way,” says Dr. Vladic.

Bottom line: If you notice your stools are in the shape of flat ribbons, see a doctor. Do not make assumptions.


A test called Cologuard can be taken at home; a sample of bowel movement is then sent out for analysis with state-of-the-art DNA technology that will detect abnormal cells that are suspicious for colon cancer.

Colon Cancer Related Constipation vs. IBS Stools

Here’s a comparison between colon cancer related constipation & IBS.

“Constipation as a symptom itself can be caused by colon cancer or irritable bowel syndrome (IBS) with predominant constipation,” says Franjo Vladic M.D., a board certified gastroenterologist with Center for Digestive Health and Endoscopy Center in Ohio, whom I interviewed for this article.

Can you tell the difference between constipation from IBS and that from colon cancer?

Dr. Vladic says, “IBS with predominant constipation is a benign condition, meaning that the patient does not present with any alarm symptoms, such as unintentional weight loss, blood in stools, abdominal distention, nausea or vomiting.

“If a patient presents with any of these alarm symptoms, coupled with constipation, their provider should consider an organic etiology being the cause of the constipation. Without any alarm symptoms, the constipation is likely from IBS or another benign condition that should not cause any potential concern.”

Does colon cancer related constipation look different than IBS constipation?

When colon cancer causes constipation, there is nothing compositionally different about the stools vs. when the constipation has a benign cause such as irritable bowel syndrome. The constipation from colon cancer is caused by an obstruction in the colon, which holds the stools back, preventing an easy void, or delaying a void (the tumor can shift out of the way, allowing backed-up stools to finally void).

IBS does not involve any abnormal composition of stool matter, either. Thus, the appearance of the stools, from colon cancer related constipation, would be the same as that from IBS, when the patient views the BMs in the toilet bowl.


The big variable is the absence—or presence—of those other alarming symptoms.

But here’s something to consider: It’s entirely possible to have both IBS and colon cancer. If you’re worried, consider a home stool test called Cologuard, which uses state-of-the-art DNA technology to detect abnormal cells in feces.

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