Melenic stool refers to black, tarry stools or blood in the stool, indicating a disturbance or lesion of digestive symptoms. It can originate from anywhere in the digestive tract and requires a complete physical exam and diagnostic tests to determine the cause. Treatment depends on the underlying condition.
The term melenic stool is sometimes used to refer to black, tarry stools, or blood in the stool. In addition, melanic stools may indicate a disturbance or lesion of digestive symptoms. Although black, tarry stools often indicate blood in the stool, a condition called hematochezia also refers to brown or red stools. Generally, blood in stool can come from anywhere in the digestive tract, from the mouth to the anus.
Generally, melanic stools indicate that the blood originates in the upper part of the gastrointestinal tract. This part of the gastrointestinal system includes the esophagus, the beginning of the small intestine, and the stomach. When stool takes on a tarry appearance, it means it has been exposed to digestive juices. Sometimes stomach ulcers caused by certain medications can cause upper gastrointestinal bleeding.
Usually, bright red stools indicate that blood is coming from the lower gastrointestinal tract, which includes the rectum, large intestine, and anus. Some conditions such as diverticulosis and hemorrhoids can cause frank blood in the stool. Rarely, abnormal blood vessels and tumor formation can cause lower gastrointestinal bleeding. Sometimes, rapid or massive gastric bleeding can cause bright red stools. Some medications such as Pepto-Bismol® and iron supplements can cause melanic stools, which are usually transient and harmless.
Sometimes, certain foods can cause melanic stools. These foods include black licorice and blueberries or blackberries. Tomatoes and beets can mimic the appearance of blood in stool and in cases like these, a doctor may perform a stool test to rule out melena. Other causes of melanic stools are gastritis, which is inflammation of the stomach lining, and intestinal ischemia. Typically, intestinal ischemia causes the intestines to lack adequate blood flow, resulting in bleeding. Rarely, a foreign body or trauma to the gastrointestinal tract can produce melanic stools.
Treatment for melanic stool depends on the cause. Determining the source of blood in the stool requires a complete physical exam and possibly blood tests that include a complete blood count. Melena can cause anemia, which can be indicated by a decrease in red blood cells. Other diagnostic tests may include a series of upper and lower GIs, ultrasound, and stool sample testing. While blood in the stool may indicate a harmless condition, other, more troubling conditions must be ruled out before an effective diagnosis can be made.
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