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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 .
Melena is four-times more likely to come from an upper gastrointestinal bleed than from the lower GI tract; however, it can also occur in either the duodenum and jejunum, and occasionally the portions of the small intestine and proximal colon. [5] Bright red stool, called hematochezia, is the sign of a fast moving active GI bleed. [1]
Hematochezia is a form of blood in stool, in which fresh blood passes through the anus while defecating. It differs from melena, which commonly refers to blood in stool originating from upper gastrointestinal bleeding (UGIB). [1] The term derives from Greek αἷμα ("blood") and χέζειν ("to defaecate").
Persons with upper gastrointestinal bleeding often present with hematemesis, coffee ground vomiting, melena, or hematochezia (maroon-coloured stool) if the hemorrhage is severe. The presentation of bleeding depends on the amount and location of hemorrhage.
Choking, coughing and unintended weight loss are other symptoms to watch for, as well as blood in your saliva or stool, or you’re vomiting blood, Dr. Nocerino says.
Oily stool, a.k.a. steatorrhea. Steatorrhea refers to bulky, foul-smelling, oily stool that tends to be pale in color and float in the toilet bowl, resisting flushing.
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]
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