Melena

What Is Melena?

Normally, the colour of your stool should be a shade of brown.  Sometimes, you may notice bright red blood in your stools, which may be a cause of concern. However, sometimes your stool may be black, which also is a condition of bloody stool.

When you have blood in the stool that causes it to become tarry and black in colour, the condition is called melena. Melena is due to the bleeding that occurs in the upper gastrointestinal tract. The condition of the blood in the stool is also known medically as hematochezia.

Any blood present in the oesophagus, small intestine, stomach or duodenum is affected by digestive enzymes, oxidation and bacteria as it passes via the large intestine and is finally eliminated through your faeces. These factors act on the stool and cause the stool to change in colour to dark red or black. The stools will also have a strong and unpleasant odour.

Only if there is around 50ml of blood present in the oesophagus, duodenum and the stomach, dark stools occur and usually, melena is not detected unless there is around 100-200ml of blood present in the gastrointestinal tract. Bleeding from these parts also causes bloody vomiting which is known as haemoptysis or hematemesis, where there is bloody phlegm that comes out while coughing.

What Is Melena?

Normally, the colour of your stool should be a shade of brown.  Sometimes, you may notice bright red blood in your stools, which may be a cause of concern. However, sometimes your stool may be black, which also is a condition of bloody stool.

When you have blood in the stool that causes it to become tarry and black in colour, the condition is called melena. Melena is due to the bleeding that occurs in the upper gastrointestinal tract. The condition of the blood in the stool is also known medically as hematochezia.

Any blood present in the oesophagus, small intestine, stomach or duodenum is affected by digestive enzymes, oxidation and bacteria as it passes via the large intestine and is finally eliminated through your faeces. These factors act on the stool and cause the stool to change in colour to dark red or black. The stools will also have a strong and unpleasant odour.

Only if there is around 50ml of blood present in the oesophagus, duodenum and the stomach, dark stools occur and usually, melena is not detected unless there is around 100-200ml of blood present in the gastrointestinal tract. Bleeding from these parts also causes bloody vomiting which is known as haemoptysis or hematemesis, where there is bloody phlegm that comes out while coughing.

What Are The Symptoms Of Melena?

The most recognisable symptom of melena is the dark red or black colour of the stool. Anaemia is another common condition that affects patients with melena and the condition of anaemia causes lack of red blood cells and both melena and anaemia cause symptoms such as:

  • Weakness
  • Fatigue
  • Fainting
  • Light-headedness
  • Pale skin
  • Shortness of breath
  • Quick pulse
  • Pain in the abdomen

What Are The Causes Of Melena?

  • Peptic ulcer, enteritis, gastritis
  •  
  • Liver cirrhosis, ulcerative Colitis
  • Arsenic poisoning, oral drug overdose
  • Cancer of upper or lower GI tract, trauma to the stomach
  • Radiation therapy, bleeding in the ascending colon or the upper GI (gastrointestinal) tract can cause the development of melena.
  • Anticoagulants like warfarin
  • Malignant tumours affecting the oesophagus, small intestine, stomach.
  • Haemorrhagic blood diseases like haemophilia (impaired blood clot function) and thrombocytopenia (low levels of thrombocytes or platelets in the blood).
  • Oesophageal varices (extremely dilated sub-mucosal veins in the oesophagus).
  • Meckel’s diverticulum (slight bulge in the small intestine).
  • Mallory-Weiss syndrome (oesophageal tear due to severe vomiting).
  • A less serious case of melena occurs in new-borns 2-3 days after delivery, due to swallowing the mother’s blood.

Sometimes there may be cases of false melena that must not be confused with the real disease and may be caused due to:

  • Having iron supplements, Pepto Bismol, lead and Maalox.
  • If you have suffered from a nose bleed and have swallowed the blood.
  • If you have consumed blood as part of your diet like black pudding or blood sausage or as part of the African Maasai diet that contains a lot of blood drained from the cattle. 

What Are The Things One Should Do To Manage Melena?

  • Change your dietary habits and adopt a healthy diet.
  • Drink plenty of water to clear the digestive system and detoxify it. 
  • Exercise regularly and maybe incorporate yoga into your exercise routine.
  • Consult your doctor immediately if you notice stools in your blood to avoid the worsening of the situation and leading to a serious condition like melena. 

What Are The Things One Should Avoid To Manage Melena?

  • Quit smoking and avoid using tobacco products.
  • Don’t eat too close to your bedtime as it may trigger your gastritis and worsen the melena. 

What Are The Best Foods For Melena?

  • Add foods that are high in fibre to your diet. Foods such as high-fibre vegetables, leafy green vegetables and fruits, etc. are a healthy addition to your diet. The fibre in these foods will help to prevent constipation and provide some relief in the condition of melena.
  • Consume whole grains and whole grain products to prevent constipation and provide relief from the symptoms of melena.
  • Take fermented foods like kimchi and coconut kefir, they can help to soothe the ulcer and be helpful for melena. 
  • Eat liquorice extract as it has inflammatory properties. You can also include fennel in your diet. Both of them can help to soothe the stomach and reduce the symptoms of gastritis and melena. Liquorice extract can be eaten in the form of supplements that are available as chewable tablets too.
  • Homemade bone broth is very good to reduce the symptoms of melena.  

What Are The Worst Foods For Melena?

  • Avoid spicy and oily foods as this irritates the stomach and GI tract and may worsen the condition of melena.
  • Avoid drinking coffee, tea, caffeine containing beverages, carbonated beverages, and alcoholic beverages as these irritate the digestive system and may worsen the condition of melena.
  • Avoid refined and processed foods like bread, pasta, rice, etc. as these can irritate the stomach if you have ulcers.
  • Eliminate sugar and sugary foods like cakes, pastries, candy, etc from your diet as these can irritate the digestive system and worsen the symptoms of melena.
  • Avoid acidic foods like oranges and tomatoes as and trigger gastritis and can cause the condition of melena to worsen. 

What Are The Medicines For Melena?

What Are The Tips To Manage Melena?

  • Reducing stress and increasing your relaxation can help to improve the symptoms of melena caused by other problems like gastritis, ulcerative colitis, etc. Stress is a known cause that can result in the flare up of the symptoms of ulcerative colitis, so it is a good idea to practice natural stress reducing techniques regularly.
  • You can do meditation and breathing exercises to reduce stress.   

What Are The Symptoms Of Melena?

The most recognisable symptom of melena is the dark red or black colour of the stool. Anaemia is another common condition that affects patients with melena and the condition of anaemia causes lack of red blood cells and both melena and anaemia cause symptoms such as:

  • Weakness
  • Fatigue
  • Fainting
  • Light-headedness
  • Pale skin
  • Shortness of breath
  • Quick pulse
  • Pain in the abdomen

What Are The Causes Of Melena?

  • Peptic ulcer, enteritis, gastritis
  •  
  • Liver cirrhosis, ulcerative Colitis
  • Arsenic poisoning, oral drug overdose
  • Cancer of upper or lower GI tract, trauma to the stomach
  • Radiation therapy, bleeding in the ascending colon or the upper GI (gastrointestinal) tract can cause the development of melena.
  • Anticoagulants like warfarin
  • Malignant tumours affecting the oesophagus, small intestine, stomach.
  • Haemorrhagic blood diseases like haemophilia (impaired blood clot function) and thrombocytopenia (low levels of thrombocytes or platelets in the blood).
  • Oesophageal varices (extremely dilated sub-mucosal veins in the oesophagus).
  • Meckel’s diverticulum (slight bulge in the small intestine).
  • Mallory-Weiss syndrome (oesophageal tear due to severe vomiting).
  • A less serious case of melena occurs in new-borns 2-3 days after delivery, due to swallowing the mother’s blood.

Sometimes there may be cases of false melena that must not be confused with the real disease and may be caused due to:

  • Having iron supplements, Pepto Bismol, lead and Maalox.
  • If you have suffered from a nose bleed and have swallowed the blood.
  • If you have consumed blood as part of your diet like black pudding or blood sausage or as part of the African Maasai diet that contains a lot of blood drained from the cattle. 

What Are The Things One Should Do To Manage Melena?

  • Change your dietary habits and adopt a healthy diet.
  • Drink plenty of water to clear the digestive system and detoxify it. 
  • Exercise regularly and maybe incorporate yoga into your exercise routine.
  • Consult your doctor immediately if you notice stools in your blood to avoid the worsening of the situation and leading to a serious condition like melena. 

What Are The Things One Should Avoid To Manage Melena?

  • Quit smoking and avoid using tobacco products.
  • Don’t eat too close to your bedtime as it may trigger your gastritis and worsen the melena. 

What Are The Best Foods For Melena?

  • Add foods that are high in fibre to your diet. Foods such as high-fibre vegetables, leafy green vegetables and fruits, etc. are a healthy addition to your diet. The fibre in these foods will help to prevent constipation and provide some relief in the condition of melena.
  • Consume whole grains and whole grain products to prevent constipation and provide relief from the symptoms of melena.
  • Take fermented foods like kimchi and coconut kefir, they can help to soothe the ulcer and be helpful for melena. 
  • Eat liquorice extract as it has inflammatory properties. You can also include fennel in your diet. Both of them can help to soothe the stomach and reduce the symptoms of gastritis and melena. Liquorice extract can be eaten in the form of supplements that are available as chewable tablets too.
  • Homemade bone broth is very good to reduce the symptoms of melena.  

What Are The Worst Foods For Melena?

  • Avoid spicy and oily foods as this irritates the stomach and GI tract and may worsen the condition of melena.
  • Avoid drinking coffee, tea, caffeine containing beverages, carbonated beverages, and alcoholic beverages as these irritate the digestive system and may worsen the condition of melena.
  • Avoid refined and processed foods like bread, pasta, rice, etc. as these can irritate the stomach if you have ulcers.
  • Eliminate sugar and sugary foods like cakes, pastries, candy, etc from your diet as these can irritate the digestive system and worsen the symptoms of melena.
  • Avoid acidic foods like oranges and tomatoes as and trigger gastritis and can cause the condition of melena to worsen. 

What Are The Medicines For Melena?

What Are The Tips To Manage Melena?

  • Reducing stress and increasing your relaxation can help to improve the symptoms of melena caused by other problems like gastritis, ulcerative colitis, etc. Stress is a known cause that can result in the flare up of the symptoms of ulcerative colitis, so it is a good idea to practice natural stress reducing techniques regularly.
  • You can do meditation and breathing exercises to reduce stress.