Melena

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Melena
Melena due to bleeding duodenal ulcer
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Black tarry stool, foul-smelling stool
Complications Anemia, hypovolemic shock
Onset Sudden or gradual
Duration Varies depending on cause
Types N/A
Causes Peptic ulcer disease, gastritis, esophageal varices, Mallory-Weiss tear
Risks NSAID use, alcohol abuse, liver cirrhosis
Diagnosis Fecal occult blood test, endoscopy
Differential diagnosis Hematochezia, iron supplementation, bismuth subsalicylate
Prevention N/A
Treatment Proton pump inhibitors, endoscopic therapy, blood transfusion
Medication N/A
Prognosis Depends on underlying cause and treatment
Frequency Common in patients with gastrointestinal bleeding
Deaths N/A


Melena or melaena refers to the dark black, tarry feces that are associated with upper gastrointestinal bleeding. The black color and characteristic strong odor are caused by hemoglobin in the blood being altered by digestive enzymes and intestinal bacteria.

Causes

Melena is often related to bleeding in the upper Gastrointestinal tract, such as from a bleeding Peptic ulcer, Gastric ulcer, or Esophageal varices. Other causes can include Iron supplements, Pepto-Bismol, and black licorice. The black color is caused by the hemoglobin in the blood being altered by digestive enzymes and intestinal bacteria.

Diagnosis

The diagnosis of Melena is made by physical examination and history. The stool is often tested for blood to confirm the presence of bleeding. Other tests may include a Complete blood count (CBC), Liver function tests, and a Coagulation profile.

Treatment

Treatment for Melena depends on the underlying cause. If the cause is an ulcer, medications to decrease stomach acid may be prescribed. If the cause is varices, a procedure called Endoscopy may be performed to stop the bleeding.

See also

References


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Contributors: Prab R. Tumpati, MD