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Melena (Tarry Stool)

Melena refers to black, tarry stools that result from bleeding in the upper gastrointestinal tract. This condition is characterized by:

  • Dark black or tarry appearance of stool
  • Foul, offensive odor
  • Sticky or shiny texture

Causes

The most common causes of melena include:

  • Peptic ulcers
  • Gastritis
  • Esophageal varices
  • Mallory-Weiss tears
  • Upper GI malignancies
  • Gastroesophageal reflux disease (GERD)
  • Use of certain medications: Such as NSAIDs, aspirin, and blood thinners

Less common causes may include angiodysplasia, Meckel’s diverticulum, or small bowel tumors.

Diagnosis

Diagnosis of melena typically involves:

  • Medical history review
  • Physical examination: Including a digital rectal exam
  • Fecal occult blood test
  • Endoscopy
  • Blood tests
  • Imaging studies: In some cases

Treatment

Treatment for melena depends on the underlying cause and may include:

  • Fluid resuscitation and blood transfusions: If necessary
  • Medications: To reduce stomach acid, such as proton pump inhibitors
  • Endoscopic procedures: To stop bleeding
  • Treatment of underlying conditions: For example, H. pylori eradication for peptic ulcers
  • Adjusting or discontinuing medications: That may contribute to bleeding
  • Surgery: In severe cases