Melena

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Melena
File:Melena Bleeding DU.jpg 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

• Hematochezia
• Gastrointestinal bleeding
• Peptic ulcer disease
• Esophageal varices