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Melena is a form of blood in stool which refers to the dark black, tarry feces that are commonly associated with upper gastrointestinal bleeding. [1] The black color and characteristic strong odor are caused by hemoglobin in the blood being altered by digestive enzymes and intestinal bacteria.
Blood in stool looks different depending on how early it enters the digestive tract—and thus how much digestive action it has been exposed to—and how much there is. The term can refer either to melena, with a black appearance, typically originating from upper gastrointestinal bleeding; or to hematochezia, with a red color, typically originating from lower gastrointestinal bleeding. [6]
Steatorrhea should be suspected when the stools are bulky, floating and foul-smelling. [1] Specific tests are needed to confirm that these properties are in fact due to excessive levels of fat. Fats in feces can be measured over a defined time (often five days). [ 14 ]
Gastroenterologists explain the most common causes of foul-smelling stool, like changes in gut bacteria, food allergies, celiac disease, IBD, and malabsorption.
Blood in stool: Red flags There are some symptoms that raise suspicion when they accompany blood in the stool, Dr. Bulsiewicz points out. These can include multiple bowel movements in a row with ...
A mucous rectal discharge may be blood-streaked. With some conditions, the blood can be homogenously mixed with the mucus, creating a pink goo. An example of this could be the so-called "red currant jelly" stools in intussusception. This appearance refers to the mixture of sloughed mucosa, mucus, and blood. [12]
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A complete blood count as well as an hemoglobin test should be performed when a patient presents symptoms of hematochezia. A colonoscopy may be necessary if there is suspicion of bleed from colon particularly in the elderly to look for the site and many causes of bleed like carcinoma, ulcerative colitis, rectal varices or other lesions and in certain instances upper gastrointestinal endoscopy ...