Your doctor will have you collect a small stool sample at home using a special kit. The sample is then sent to a lab for evaluation. If you're diagnosed with melena, doctors may order further diagnostic tests to determine the cause and the exact location of the bleeding.
Specifically, your doctor may conduct an esophagogastroduodenoscopy EGD, or upper endoscopy. This procedure involves inserting a flexible tube with a camera down your throat so that your healthcare provider can inspect the lining of the esophagus, stomach, and upper intestine.
Stool that is visibly black and tarry typically indicates the presence of an acute condition in the upper GI tract. After the bleeding has stopped, stool may continue to appear black and tarry for several days. Possible causes of melena include a bleeding ulcer, gastritis, esophageal varices enlarged veins , or a tear in the esophagus from violent vomiting Mallory-Weiss tear.
An ulcer is a type of sore on the lining of the stomach that can cause bleeding and result in melena. Contrary to popular belief, stomach ulcers are not usually caused by stress or spicy food, although these can aggravate an already existing ulcer. In fact, stomach ulcers are usually caused by an infection with bacteria called Helicobacter pylori H. Long-term use of pain medications , known as nonsteroidal anti-inflammatory drugs NSAIDs , are another cause of stomach ulcers.
NSAIDs include common over-the-counter drugs, such as ibuprofen, naproxen sodium, and aspirin. NSAIDs can irritate the stomach by weakening the lining's ability to resist acid made in the stomach. For this same reason, NSAIDs have an adverse effect on Crohn's disease and ulcerative colitis —conditions that cause ulcers and inflammation of the GI tract.
Gastritis is inflammation of the stomach lining. This inflammation can be caused by too much alcohol, eating spicy foods, smoking, infection with bacteria, or by the prolonged use of NSAIDs. Gastritis can also develop after surgery or trauma, or it may be associated with already existing medical conditions.
Gastritis that is left untreated can lead to stomach ulcers and other complications. Some people have no symptoms, while acute, suddenly occurring cases of gastritis may only result in tarry, black stool.
Persistent bleeding can lead to more severe symptoms like:. Esophageal varices are enlarged veins in the wall of the lower esophagus or upper stomach. When these veins rupture, they may cause bleeding and lead to blood in the stool or in vomit.
Esophageal varices are serious complications resulting from high blood pressure brought on by cirrhosis of the liver. Most people with esophageal varices experience no symptoms unless the veins rupture. Symptoms of bleeding esophageal varices include:. Mallory-Weiss tear is a tear in the mucous membrane that joins the esophagus and the stomach.
If this tear bleeds, it can result in melena. This condition is fairly rare. It only only occurs in about seven out of , people in the US and may be caused by violent vomiting, coughing, or epileptic convulsions. Like other conditions that cause melena, symptoms of a Mallory-Weiss tear may not be obvious. Along with tarry, black stool, some people may experience any of the following:.
Blood in the stool can be a serious concern. Blood in your bowel movements is usually caused by one of these conditions:. Doctors may need to examine a sample of your stool or may need to insert a camera into your GI track to determine where the blood is coming from.
Stomach ulcers caused by and infection may be treated with antibiotics. Your healthcare provider may also recommend an acid reducer. If your doctors suspects gastritis, they may prescribe antacids or proton pump inhibitors , antibiotics that treat H. If these treatments fail to resolve your symptoms, your healthcare provider may order an upper endoscopy to take a closer look at your stomach and small intestine.
Esophageal Varices requires immediate medical care to help stop the bleeding. Elastic bands may be wrapped around the varices to stop the flow of blood. Stents , tubes inserted to manage blood flow, may be used to lower blood pressure. That can reduce the amount of bleeding. In the case of a Mallory-Weiss tear, the tear heals on its own for most people.
If it does not resolve itself, you may need treatment to seal the lesion. This may either take the form of a medication that is injected internally, or a type of heat therapy known as electrocoagulation. Stool that appears black is not always a sign of a bigger health problem. Your stool can look black as a result of food or iron supplements you have eaten. If that's the case, the color will return to normal within a day or so.
If it doesn't, and if you cannot trace it back to something you have eaten, ask yourself:. If you answered yes to one or more of these questions, or if you're experiencing symptoms like nausea, vomiting, or lightheadedness, you should contact your doctor.
Though it may be surprising to see, occasional black stool is not something to worry about so long as it occurs after you eat dark-colored foods or take an iron supplement.
That said, if black or tarry stools cannot be attributed to something you have consumed, or you simply feel like something is off, it's best to get checked out. Some of the conditions that cause GI bleeding can be life-threatening unless treated promptly. Not necessarily. Dark-colored stool may just be the result of food you ate or supplements you took.
Black stools caused by these kinds of upper GI issues are sometimes referred to as melena. A few of these conditions include:. Many of these conditions are serious and include a host of other gastrointestinal symptoms. If your stools have been black and tarry for a few days, and are accompanied by stomach aches and vomiting, you should seek medical help immediately. The esophagus is a tube that carries foods and liquids to the stomach.
When veins inside the esophagus become swollen — a condition usually connected to cirrhosis or other advanced liver diseases — they can occasionally rupture and cause both red, bloody stools, or black, tarry stools.
If your symptoms are not severe enough to warrant a hospital visit, your doctor will likely ask about your medical history and perform a physical examination to try to determine the cause of your unusual stool color.
Your doctor may also schedule a gastroscopy or colonoscopy to assess the condition of your gut. Your doctor will insert a thin, flexible tube through your anus into the rectum with a camera on the end to see the inside of your colon and look for the cause of your symptoms. A gastroscopy is similar in nature to a colonoscopy but focuses on the esophagus, stomach, and small intestine.
The thin tube is inserted through your throat, rather than the anus. The same goes for iron supplements and medicines containing bismuth subsalicylate: If you think your black stools may be connected to taking either of these, talk with your doctor about safe alternatives. If your black stools are due to a condition that is causing upper GI bleeding, your treatment will vary depending on the severity of the condition.
Black stools can be caused by a variety of issues, from eating too much black licorice to bleeding in your gastrointestinal tract. The key to identifying how serious your condition is are the other symptoms that are present. If you are experiencing nausea, stomach upset, dizziness, or abdominal pain along with black stools, contact your doctor quickly.
Your diet may be the culprit behind black specks in your stool. Hard poop can be a symptom of lifestyle factors, medications taken, or an underlying medical condition. There are several different approaches to….
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