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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.
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Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper gastrointestinal hemorrhage. Specialty: Gastroenterology: Symptoms: Hematemesis (vomiting blood), coffee ground vomiting, melena, hematochezia (maroon-coloured stool) in severe cases
The differential diagnosis can be complicated somewhat if the person exhibits only vomiting or diarrhea (rather than both). [1] Appendicitis may present with vomiting, abdominal pain, and a small amount of diarrhea in up to 33% of cases. [1] This is in contrast to the large amount of diarrhea that is typical of gastroenteritis. [1]
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]
Bile acid malabsorption (BAM), known also as bile acid diarrhea, is a cause of several gut-related problems, the main one being chronic diarrhea.It has also been called bile acid-induced diarrhea, cholerheic or choleretic enteropathy, bile salt diarrhea or bile salt malabsorption.
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] A number of foods and medications can turn the stool either red or black in the absence of bleeding. [2]
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