Is your poop black? Let's talk about Melena!

When you go to the toilet and see that your stool is a different, strange black color than usual, everyone gets a little scared, right? A lot of things come to mind. "Is this something dangerous? Why is this happening to me?" It's normal to think. This is actually a symptom that should not be ignored, and it can be very important. So today we'll talk about this black stool, which is what we medically call Melena.

What is Melena?

Simply put, melena is black, tarry stools caused by bleeding in the upper part of your digestive system, that is , in the stomach or upper part of the small intestine .

Imagine, even though blood is red, as it travels from the stomach to the intestines, it reacts with the digestive chemicals in our body. Just like a piece of iron rusts when exposed to the sun, as this blood travels through the digestive tract for a long time, its color changes and it becomes black, sticky, and tarry. That's what we call melena.

What is the difference between melena and normal black stool?

The important thing to understand here is that not every time your stool turns black, it's because of bleeding. Certain foods and medications can also cause your stool to turn black. It's only when a doctor examines your stool and confirms that there is blood in it that it is called melena.

Let's clearly distinguish this difference.

What if there is blood coming from the lower part?

You may wonder why not all bleeding is black. The reason is where the bleeding is coming from. If the bleeding is from somewhere lower in the digestive tract, such as the large intestine, it doesn't take long for the blood to come out. That's why it comes out in the stool as a bright red color .

What are the main causes of Melena?

There are several possible causes of upper gastrointestinal bleeding, some of which are serious.

• Peptic ulcer disease: This is the most common cause. These ulcers can occur when the condition known as gastritis becomes severe.
• Severe inflammation of the stomach or esophagus (gastritis or esophagitis): The stomach wall or esophagus (food pipe) becomes swollen and inflamed.
• Acute hemorrhagic erosive gastropathy: Some medications, such as painkillers, or excessive alcohol consumption can cause the stomach wall to become eroded and bleed.
• Gastrointestinal perforation: A perforation of the digestive tract due to an accident or other cause.
• Varicose veins in the esophagus or stomach: Varicose veins in the esophagus and stomach, especially in people with liver disease, can become swollen and rupture, causing severe bleeding.
• Tearing of the esophagus due to excessive vomiting: When vomiting continuously and with excessive force, the esophagus can tear and bleed.
• Cancerous conditions: Cancerous conditions in the stomach, esophagus, or pancreas can also cause bleeding.
• Viral fevers such as Ebola: Although these are not common in Sri Lanka, some severe viral diseases can also cause internal bleeding.

Other reasons why stool may be black without bleeding

Before you panic, consider whether these things are also causing your stool to turn black.

• Iron tablets: It is very common for stools to turn black when taking iron tablets for anemia. This is normal and nothing to worry about.
• Certain medications: Certain medications containing bismuth subsalicylate, which are used to treat stomach problems, can also cause black stools.
• Activated charcoal: This medicine, which is given when poison is ingested, also turns the stool black.
• Dark-colored foods: Eating large amounts of dark-colored foods, such as blood sausage, blueberries, and purple grapes, can also change the color of your stool.

Why should you see a doctor and what tests are done?

If you have even the slightest suspicion that you have Melena, the best thing to do is to see a doctor, rather than just guessing at home. The doctor will ask you questions, run the necessary tests, and find the cause.

Before starting treatment, it is important to determine the exact cause of the bleeding. This can be done by performing tests such as:

• Fecal Occult Blood Test: This can detect whether there is a small amount of blood in the stool that is not visible to the eye.
• Blood tests: They can give you an idea of ​​how much blood your body has lost and what is causing the bleeding.
• Scans: Tests such as a CT scan or CT angiogram can help locate the bleeding site.
• Upper endoscopy (EGD test): This is the most important and most commonly performed test. A thin, flexible tube with a camera attached is inserted through the mouth and examined the esophagus, stomach, and the beginning of the small intestine. This can help to see exactly where the bleeding is, sometimes treat it right away, and take a small piece of tissue for examination (a `biopsy`).

Risk symptoms that require immediate hospital admission

If you have these symptoms along with black stools, go to a hospital's emergency department (ETU) immediately, as these could be signs of severe bleeding.

• Vomiting blood (fresh red or brown like coffee grounds).
• Severe dizziness, feeling light-headed, and fainting.
• Rapid heartbeat and difficulty breathing.
• Black stools for several days in a row.

Melena, black stool, GI bleeding, peptic ulcer, blood in stool, doctor