Melena is the term used for black coal tar colored stool. It is caused due to passage of blood in stool. When iron from hemoglobin gets decomposed in intestine while passing through, it gives dark black color to the stool.
Melena is an abnormal condition caused when there is bleeding from upper gastrointestinal region i.e. stomach and duodenum. The lower intestine hemorrhage is usually bright red. It is the first sign of upper gastrointestinal bleeding, which is important for diagnosis of disease such as peptic ulcer.
Symptoms And Causes Of Melena
Symptoms of melena or blood in stool are:
- Patient complains change of stool color to his medical attendant; it is dark black like coal tar.
- Anemia is most important sign noted in patients with melena.
- Pain in abdomen, due to peptic ulcer.
Causes Of Melena
Black stool or melena causes include:
- Peptic ulcer that includes stomach ulcer, duodenal ulcer.
- Stomach cancer.
- Patient on anti-coagulant drugs such as Warfarin may cause melena.
- Gastritis (inflammation of stomach) and esophageal varices.
- Hemorrhagic blood disease such as purpura.
- Swallowed blood as in case of nose bleeding can also give rise to melena.
- Intestinal worms.
Functional causes of melena with no significant clinical importance are supplementary iron consumption.
Infants may present with melena after birth, due to swallowing of maternal blood during delivery.
Treatment For Melena
- Diagnosis of disease after patient having melena is important. For this laboratory stool examination, upper GI endoscopy and barium X-ray helps the medical attendant to find the cause.
- Treatment will depend on the cause. In case of peptic ulcer, conservative line of treatment will heal the ulcer, bland diet, medications for H.pylori infection will cure melena.
- Gastric cancer will need more invasive therapy such as operation.
- Esophageal varies will require banding.
- If worms are involved, patient has to be dewormed with medications.