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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.
“Unabsorbed iron can form complexes with compounds in your gastrointestinal tract that can lead to black stools,” says Samuel A. Akinyeye, M.D., assistant professor in the division of ...
A number of foods and medications can turn the stool either red or black in the absence of bleeding. [2] Bismuth found in many antacids may turn stools black as may activated charcoal. [2] Blood from the vagina or urinary tract may also be confused with blood in the stool. [2]
Endoscopic treatment is an initial possibility, where cautery or argon plasma coagulation (APC) treatment is applied through the endoscope. Failing this, angiography and embolization with particles is another microinvasive treatment option, which avoids the need for surgery and bowel resection.
Recurrent or refractory bleeding may lead to need for surgery, although this has become uncommon as a result of improved endoscopic and medical treatment. Upper gastrointestinal bleeding affects around 50 to 150 people per 100,000 a year. It represents over 50% of cases of gastrointestinal bleeding. [2]
Blood in your stool or black or tarry stool (which may indicate cancer higher up in the colon and is more common among women, according to Mongiu) Abdominal pain, aches or cramps
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]
A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
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