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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.
Patients with hemosuccus may develop symptoms of gastrointestinal hemorrhage, such as blood in the stools, maroon stools, or melena, which is a dark, tarry stool caused by digestion of red blood cells. They may also develop abdominal pain. It is associated with pancreatitis, pancreatic cancer and aneurysms of the splenic artery.
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]
“The tarry or stickiness of the stool and the smell are what differentiate true GI bleeding from other causes such as iron supplements, dark foods, and bismuth-containing medications,” he adds.
The presence of bright red blood in stool, known as hematochezia, typically indicates lower gastrointestinal bleeding. Digested blood from the upper gastrointestinal tract may appear black rather than red, resulting in "coffee ground" vomit or melena. [2] Other signs and symptoms include feeling tired, dizziness, and pale skin color. [18]
Blood may be observed in vomit or in altered form as black stool. Depending on the amount of the blood loss, symptoms may include shock. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer. The initial assessment includes measurement of the blood pressure ...
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 ...
Fecal occult blood testing (FOBT), as its name implies, aims to detect subtle blood loss in the gastrointestinal tract, anywhere from the mouth to the colon.Positive tests ("positive stool") may result from either upper gastrointestinal bleeding or lower gastrointestinal bleeding and warrant further investigation for peptic ulcers or a malignancy (such as colorectal cancer or gastric cancer).