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Melena is a medical condition, which describes a passage of black tarry faeces. In general, this type of symptom is associated with upper gastrointestinal haemorrhage. The stool discolouration comes from high concentration of haemoglobin, which is afterwards changing its tone due to susceptibility to the digestive chemicals properties.
Melena is occasionally confused with haematochezia, although those are two different conditions. Haematochezia is the excretion of fresh bright blood during defecation, but on the contrary of melena, it is connected with lower gastrointestinal haemorrhage.
Possible causes of melena
Melena originates from upper gastrointestinal haemorrhage. There are various disorders, that can result in this type of bleeding. The most common ones, however, include:
- Peptic ulcer disease, also referred to as stomach ulcer.
- Mallory–Weiss syndrome, which appears as a consequence of violent or frequent vomiting.
- Overdose of certain drugs, such as anticoagulants.
- Oesophagus, stomach or small intestine tumours
- Meckel’s diverticulum
It is worth to remember, that there are “false” incidents as well. Certain factors can actually transform the looks of faeces, so they resemble those seen during legitimate melena. They may include for instance:
- Too high consumption of iron and lead, either from food or dietary supplements.
- Use of certain medications, such as bismuth subsalicylate or antacids.
- To high consumption of black pudding
Associated symptoms and signs
This type of ailment can be accompanied by set of other symptoms and signs. The most common features may include:
- Abdominal pain
- General weakness
- Breathing difficulties
- Involuntary weight loss
In addition, melena may appear along with hematemesis. Hematemesis is a condition characterized by blood in vomit. In majority of the cases, it appears as a consequence of upper gastrointestinal tract haemorrhage, as in the case of melena.
The diagnostic process can be time consuming and complicated, since there are numerous reasons of melena. At the beginning, a specialist will certainly investigate medical history of the patient and perform physical examination. The check-up will presumably be focused on the abdomen, rectum, or both of those areas. In addition, there are several test which may help to establish the diagnosis. They may include, for instance, complete blood count, colonoscopy, stool test, endoscopy or angiography.
When it comes to a treatment, there is no cure for melena exclusively. In certain incidents, however, a specialist may be able to stop the bleeding by performing an endoscopy. This method can be accompanied with either chemical injection or laser, which are applied close to the bleeding source. Nevertheless, it is a temporary solution. Taking care of the underlying disorder is the most important part of treatment.
When to see a doctor
Melena appears as a consequence of various disorders, including those life threatening. It is recommended to see a healthcare professionals as soon as the ailment appears. In fact, any form of bleeding from the anus, including incidents associated with defecation, may indicate harmful condition.