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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.
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. [2] The stool is often hard and dry. [4] Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. [3]
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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Acute bleeding from Cameron lesions, vomiting blood, or passing black bowel movements, is rare; in one report Cameron lesions were found in 3.8% of people presenting with anemia, but in only 0.2% of those with acute bleeding. [14]
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]
Pelvic floor dysfunction, rectal nerve issues, and weakened anal sphincter muscles can also impact continence, or our control over bowel movements, and how much stool or residue is left behind ...
The strongest predictors of an upper gastrointestinal bleed are black stool, age <50 years, and blood urea nitrogen/creatinine ratio 30 or more. [ 8 ] [ 9 ] The diagnosis of upper gastrointestinal bleeding is assumed when hematemesis (vomiting of blood) is observed.