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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]
Causes of lower GI bleeds include: hemorrhoids, cancer, and inflammatory bowel disease among others. [2] [1] Small amounts of bleeding may be detected by fecal occult blood test. [1] Endoscopy of the lower and upper gastrointestinal tract may locate the area of bleeding. [1] Medical imaging may be useful in cases that are not clear. [1]
The Crohn's Disease Endoscopic Index of Severity (CDEIS) is a scoring system used during endoscopy to evaluate Crohn's disease severity. It assesses six factors: deep and shallow ulcers, nonulcerated and ulcerated stenosis, the area covered by ulcers, and the overall disease-affected area across five intestinal sections.
Shigellosis, known historically as dysentery, is an infection of the intestines caused by Shigella bacteria. [1] [3] Symptoms generally start one to two days after exposure and include diarrhea, fever, abdominal pain, and feeling the need to pass stools even when the bowels are empty. [1]
The toxogenic species do not invade, but cause cellular damage by secreting toxins, resulting in bloody diarrhea. This is also in contrast to toxins that cause watery diarrhea, which usually do not cause cellular damage, but rather they take over cellular machinery for a portion of life of the cell.
Other celiac symptoms include pain, bloating, diarrhea, fatigue, joint pain, and other health problems, like infertility, malnutrition, and osteoporosis. cropped shot of man's midsection on gray ...
The history in these patients should focus on factors that could be associated with potential causes: blood coating the stool suggests hemorrhoidal bleeding while blood mixed in the stool implies a more proximal source; bloody diarrhea and tenesmus is associated with inflammatory bowel disease while bloody diarrhea with fever and abdominal pain ...
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