Melena

Learn more about an Melena and other medical symptoms..

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In medicine, melaena or melena refers to the black, "tarry" feces that are associated with gastrointestinal hemorrhage. The black color is caused by oxidation of the iron in hemoglobin during its passage through the ileum and colon.

Bleeding originating from the lower GI tract (such as the sigmoid colon and rectum) is generally associated with the passage of bright red blood, or hematochezia, particularly when brisk. Blood acts as a cathartic agent in the intestine, promoting its prompt passage. Only blood that originates from a high source (such as the small intestine), or bleeding from a lower source that occurs slowly enough to allow for oxidation, is associated with melena. For this reason, melena is often associated with hemorrhage in the stomach or duodenum (upper gastrointestinal tract), for example by a peptic ulcer.

If a source in the upper GI tract is suspected, an upper endoscopy is usually performed to diagnose the cause. Lower GI bleeding sources may be detected by tagged red blood cell scan or mesenteric angiogram.

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