hematochezia dieulafoy melena hematemesis cholangitis peptic megacolon proctitis volvulus gastritis gallstones maalox sclerosing ulcer diverticulum fistula endoscopy lesshaft mirizzi gastroenterocolitis grynfeltt gastroptosis pseudoobstruction ménétrier jejunitis spigelian cholecystolithiasis anismus malabsorption peliosis
minimum amount of gi bleed to cause melena
Melena - wikipedia Melena Jump to : navigation , search For the flowering plant , see Cymbalaria muralis . For Cuban towns with similar names , see Melena del Sur and Güira de Melena . For other uses , see Malena ( disambiguation ) , Malina ( disambiguation ) , Melina ( disambiguation ) , Milena ( disambiguation ) , Milina , Molena , and Molina ( disambiguation ) . ( hide ) This article has multiple issues . Please help improve it or discuss these issues on the talk page . ( Learn how and when to remove these template messages ) This article needs more medical references for verification or relies too heavily on primary sources . Please review the contents of the article and add the appropriate references if you can . Unsourced or poorly sourced material may be challenged and removed . ( January 2010 ) This article relies largely or entirely on a single source . Relevant discussion may be found on the talk page . Please help improve this article by introducing citations to additional sources . ( December 2011 ) This article includes a list of references , but its sources remain unclear because it has insufficient inline citations . Please help to improve this article by introducing more precise citations . ( December 2011 ) ( Learn how and when to remove this template message ) ( Learn how and when to remove this template message ) <Th_colspan="2"> Melena <Th_colspan="2"> Classification and external resources Specialty General surgery , gastroenterology ICD - 10 K92. 1 ICD - 9 - CM 578.1 MedlinePlus 003130 <Td_colspan="2"> ( edit on Wikidata ) Melena or melæna refers to the dark black , tarry feces that are associated with upper gastrointestinal bleeding . The black color and characteristic strong odor are caused by hemoglobin in the blood being altered by digestive enzymes and intestinal bacteria . Iron supplements may cause a grayish - black stool that should be distinguished from melena . Contents ( hide ) 1 Causes 2 Diagnosis 2.1 Melena versus hematochezia 3 Etymology 4 See also 5 References Causes ( edit ) The most common cause of melena is peptic ulcer disease . However , any bleeding within the upper gastrointestinal tract or the ascending colon can lead to melena . Melena may also be a complication of anticoagulant medications , such as warfarin . Causes of upper gastrointestinal bleeding that may result in melena include malignant tumors affecting the esophagus , stomach or small intestine , hemorrhagic blood diseases , such as thrombocytopenia and hemophilia , gastritis , esophageal varices , Meckel 's diverticulum and Mallory - Weiss syndrome . Causes of `` false '' melena include iron supplements , Pepto - Bismol , Maalox , and lead , blood swallowed as a result of a nose bleed ( epistaxis ) , and blood ingested as part of the diet , as with consumption of black pudding ( blood sausage ) , or with the traditional African Maasai diet , which includes much blood drained from cattle . Melena is often a medical emergency as it arises from a significant amount of bleeding . Urgent care is required to rule out serious causes and prevent potentially life - threatening emergencies . A less serious , self - limiting case of melena can occur in newborns two to three days after delivery , due to swallowed maternal blood . Diagnosis ( edit ) In acute cases , with a large amount of blood loss , patients may present with anemia or low blood pressure . However , aside from the melena itself , many patients may present with few symptoms . Often , the first approach is to use endoscopy to look for obvious signs of a bleed . In cases where the source of the bleed is unclear , but melena is present , an upper endoscopy is recommended , to try to ascertain the source of the bleed . Lower gastrointestinal bleeding sources usually present with hematochezia or frank blood . A test with poor sensitivity / specificity that may detect the source of bleeding is the tagged red blood cell scan . This is especially used for slow bleeding ( < 0.5 ml / min ) . However , for rapid bleeding ( > 0.5 ml / min ) , mesenteric angiogram ± embolization is the gold standard . Colonoscopy is often first line , however . Melena versus hematochezia ( edit ) Bleeds that originate from the lower gastrointestinal tract ( such as the sigmoid colon and rectum ) are generally associated with the passage of bright red blood , or hematochezia , particularly when brisk . Only blood that originates from a more proximal source ( such as the small intestine ) , or bleeding from a lower source that occurs slowly enough to allow for enzymatic breakdown , is associated with melena . For this reason , melena is often associated with blood in the stomach or duodenum ( upper gastrointestinal bleeding ) , for example by a peptic ulcer . A rough estimate is that it takes about 14 hours for blood to be broken down within the intestinal lumen ; therefore if transit time is less than 14 hours the patient will have hematochezia , and if greater than 14 hours the patient will exhibit melena . One often - stated rule of thumb is that melena only occurs if the source of bleeding is above the ligament of Treitz although , as noted below , exceptions occur with enough frequency to render it unreliable . Etymology ( edit ) The origin of melena is dated to the early 19th century via modern Latin , via Greek melaina ( feminine of melas , black ) . See also ( edit ) Blood in stool Hematemesis Dieulafoy 's lesion References ( edit ) Jump up ^ MedlinePlus Encyclopedia Bloody or tarry stools , retrieved 19 July 2010 . Jump up ^ Walker , Brian ; Colledge , Nicki ; Ralston , Stuart ; Penman , Ian , eds. ( 2014 ) . Davidson 's Principles and Practice of Medicine ( 22th ed . ) . Edinburgh : Churchill Livingstone . p. 854 . ISBN 978 - 0 - 7020 - 5103 - 6 . Jump up ^ Navarra , Tova ( 2004 ) . The Encyclopædia of Vitamins , Minerals , and Supplements . Infobase Publishing . Iron supplements cause a grayish - black stool that should be distinguished from the black , tarlike stool that occurs from bleeding ulcer . Jump up ^ Walker , HK ; Hall , WD ; Hurst , JW ( 1990 ) . Clinical Methods : The History , Physical , and Laboratory Examinations . Melena strongly suggests , and hematemesis confirms , that bleeding is of upper gastrointestinal origin ... Peptic ulcer , the most common cause of gastrointestinal hemorrhage , should be pursued through questions about epigastric distress , the relationship of symptoms to food intake , and a past history of peptic ulcer disease . Jump up ^ Talley , Nicholas ; O'Connor , Simon ( 2014 ) . Clinical Examination : A Systematic Guide To Physical Diagnosis ( 7th ed . ) . Chatswood : Churchill Livingstone . p. 179 . ISBN 9780729541473 . Jump up ^ Di Minno , Alessandro ; Spadarella , Gaia ; Spadarella , Emanuela ; Tremoli , Elena ; Di Minno , Giovanni ( 2015 ) . `` Gastrointestinal bleeding in patients receiving oral anticoagulation : Current treatment and pharmacological perspectives '' . Thrombosis Research . 136 ( 6 ) : 1074 -- 81 . doi : 10.1016 / j. thromres. 2015.10. 016 . access - date = requires url = ( help ) ^ Jump up to : Laine , Loren ( 2012 ) . `` 41 . Gastrointestinal Bleeding '' . In Longo , Dan L ; Fauci , Anthony S ; Kasper , Dennis L ; Hauser , Stephen L ; Jameson , J. Larry ; Loscalzo , Joseph . Harrison 's principles of internal medicine ( 18th ed . ) . New York : McGraw - Hill . p. 320 . ISBN 978 - 0 - 07 - 174889 - 6 . <Th_colspan="2"> Diseases of the digestive system ( primarily K20 -- K93 , 530 -- 579 ) Upper GI tract Esophagus Esophagitis Candidal Eosinophilic Herpetiform Rupture Boerhaave syndrome Mallory - Weiss syndrome UES Zenker 's diverticulum LES Barrett 's esophagus Esophageal motility disorder Nutcracker esophagus Achalasia Diffuse esophageal spasm Gastroesophageal reflux disease ( GERD ) Laryngopharyngeal reflux ( LPR ) Esophageal stricture Megaesophagus Stomach Gastritis Atrophic Ménétrier 's disease Gastroenteritis Peptic ( gastric ) ulcer Cushing ulcer Dieulafoy 's lesion Dyspepsia Pyloric stenosis Achlorhydria Gastroparesis Gastroptosis Portal hypertensive gastropathy Gastric antral vascular ectasia Gastric dumping syndrome Gastric volvulus Lower GI tract : Intestinal / Enteropathy Small intestine ( Duodenum / Jejunum / Ileum ) Enteritis Duodenitis Jejunitis Ileitis Peptic ( duodenal ) ulcer Curling 's ulcer Malabsorption : Coeliac Tropical sprue Blind loop syndrome Small bowel bacterial overgrowth syndrome Whipple 's Short bowel syndrome Steatorrhea Milroy disease Bile acid malabsorption Large intestine ( Appendix / Colon ) Appendicitis Colitis Pseudomembranous Ulcerative Ischemic Microscopic Collagenous Lymphocytic Functional colonic disease IBS Intestinal pseudoobstruction / Ogilvie syndrome Megacolon / Toxic megacolon Diverticulitis / Diverticulosis Large and / or small Enterocolitis Necrotizing Gastroenterocolitis IBD Crohn 's disease Vascular : Abdominal angina Mesenteric ischemia Angiodysplasia Bowel obstruction : Ileus Intussusception Volvulus Fecal impaction Constipation Diarrhea Infectious Intestinal adhesions Rectum Proctitis Radiation proctitis Proctalgia fugax Rectal prolapse Anismus Anal canal Anal fissure / Anal fistula Anal abscess Anal dysplasia Pruritus ani GI bleeding / BIS Upper Hematemesis Melena Lower Hematochezia Accessory Liver Hepatitis Viral hepatitis Autoimmune hepatitis Alcoholic hepatitis Cirrhosis PBC Fatty liver NASH Vascular Budd - Chiari syndrome Hepatic veno - occlusive disease Portal hypertension Nutmeg liver Alcoholic liver disease Liver failure Hepatic encephalopathy Acute liver failure Liver abscess Pyogenic Amoebic Hepatorenal syndrome Peliosis hepatis Metabolic disorders Wilson 's disease Hemochromatosis Gallbladder Cholecystitis Gallstones / Cholecystolithiasis Cholesterolosis Rokitansky - Aschoff sinuses Postcholecystectomy syndrome Porcelain gallbladder Bile duct / Other biliary tree Cholangitis Primary sclerosing cholangitis Secondary sclerosing cholangitis Ascending Cholestasis / Mirizzi 's syndrome Biliary fistula Haemobilia Gallstones / Cholelithiasis Common bile duct Choledocholithiasis Biliary dyskinesia Sphincter of Oddi dysfunction Pancreatic Pancreatitis Acute Chronic Hereditary Pancreatic abscess Pancreatic pseudocyst Exocrine pancreatic insufficiency Pancreatic fistula Abdominopelvic Hernia Diaphragmatic Congenital Hiatus Inguinal Indirect Direct Umbilical Femoral Obturator Spigelian Lumbar Petit 's Grynfeltt - Lesshaft Undefined location Incisional Internal hernia Richter 's Peritoneal Peritonitis Spontaneous bacterial peritonitis Hemoperitoneum Pneumoperitoneum NDL : 00562313 Retrieved from `` https://en.wikipedia.org/w/index.php?title=Melena&oldid=798957997 '' Categories : Bleeding Digestive disease symptoms Feces Hidden categories : Pages using citations with accessdate and no URL Articles needing additional medical references from January 2010 All articles needing additional references Articles needing additional references from December 2011 Articles lacking in - text citations from December 2011 All articles lacking in - text citations Talk Contents About Wikipedia Català Deutsch Eesti Español Français 한국어 Hrvatski Italiano Қазақша Nederlands 日本 語 ଓଡ଼ିଆ Polski Português Русский Slovenčina Српски / srpski Srpskohrvatski / српскохрватски Suomi Svenska Edit links This page was last edited on 4 September 2017 , at 20 : 16 . Text is available under the Creative Commons Attribution - ShareAlike License ; additional terms may apply . By using this site , you agree to the Terms of Use and Privacy Policy . Wikipedia ® is a registered trademark of the Wikimedia Foundation , Inc. , a non-profit organization . About Wikipedia