52:
129:
420:. 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
607:
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 history of peptic
360:
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,
648:
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".
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731:
272:
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
279:
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
364:
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
400:), 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
1646:
365:
687:
Laine, Loren (2012). "41. Gastrointestinal
Bleeding". In Longo, Dan L; Fauci, Anthony S; Kasper, Dennis L; Hauser, Stephen L; Jameson, J. Larry; Loscalzo, Joseph (eds.).
345:
as it arises from a significant amount of bleeding. Urgent care is required to rule out serious causes and prevent potentially life-threatening emergencies.
824:
1328:
244:
may cause a grayish-black stool that should be distinguished from melena, as should black coloration caused by a number of medications, such as
923:
552:
Iron supplements cause a grayish-black stool that should be distinguished from the black, tarlike stool that occurs from bleeding ulcer.
962:
348:
A less serious, self-limiting case of melena can occur in newborns two to three days after delivery, due to swallowed maternal blood.
817:
1190:
696:
531:
514:
1102:
842:
2117:
1403:
810:
368:. This is especially used for slow bleeding (<0.5 ml/min). However, for rapid bleeding (>0.5 ml/min), mesenteric
2075:
1922:
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421:
95:
73:
66:
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1961:
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223:
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2026:
1872:
569:
1781:
1300:
908:
995:
1361:
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891:
1634:
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1543:
1349:
967:
195:
1980:
1660:
1295:
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941:
928:
898:
869:
761:
300:
60:
28:
1905:
1682:
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1215:
874:
40:
36:
32:
24:
20:
1985:
1709:
1692:
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396:, particularly when brisk. Only blood that originates from a more proximal source (such as the
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790:
565:
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245:
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although, as noted below, exceptions occur with enough frequency to render it unreliable.
8:
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Walker, HK; Hall, WD; Hurst, JW (1990). "Hematemesis, Melena, and
Hematochezia".
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2015:
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In acute cases, with a large amount of blood loss, patients may present with
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Walker, Brian; Colledge, Nicki; Ralston, Stuart; Penman, Ian, eds. (2014).
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Bleeds that originate from the lower gastrointestinal tract (such as the
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Clinical
Methods: The History, Physical, and Laboratory Examinations
392:) are generally associated with the passage of bright red blood, or
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409:
273:
253:
330:), and blood ingested as part of the diet, as with consumption of
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509:(22nd ed.). Edinburgh: Churchill Livingstone. p. 854.
1948:
1452:
735:
627:(7th ed.). Chatswood: Churchill Livingstone. p. 179.
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357:
319:
226:. The black color and characteristic strong odor are caused by
625:
Clinical
Examination: A Systematic Guide To Physical Diagnosis
1398:
1128:
401:
219:
504:
323:
832:
533:
The
Encyclopædia of Vitamins, Minerals, and Supplements
691:(18th ed.). New York: McGraw-Hill. p. 320.
338:
diet, which includes much blood drained from cattle.
713:
619:
334:(blood sausage), or with the traditional African
2104:
588:
326:, blood swallowed as a result of a nose bleed (
507:Davidson's Principles and Practice of Medicine
818:
379:
361:to try to ascertain the source of the bleed.
924:Esophagogastric junction outflow obstruction
682:
680:
963:Esophageal intramural pseudodiverticulosis
825:
811:
689:Harrison's principles of internal medicine
127:
677:
96:Learn how and when to remove this message
498:
59:This article includes a list of general
563:
529:
436:is dated to the early 19th century via
2105:
218:which refers to the dark black, tarry
1947:
1191:Small intestinal bacterial overgrowth
806:
686:
613:
372:± embolization is the gold standard.
45:
268:The most common cause of melena is
13:
222:that are commonly associated with
65:it lacks sufficient corresponding
14:
2134:
2076:Spontaneous bacterial peritonitis
1923:Exocrine pancreatic insufficiency
709:
310:Causes of "false" melena include
16:Medical condition with dark feces
1821:Secondary sclerosing cholangitis
50:
1062:Gastric antral vascular ectasia
1057:Portal hypertensive gastropathy
934:Gastroesophageal reflux disease
414:upper gastrointestinal bleeding
224:upper gastrointestinal bleeding
1816:Primary sclerosing cholangitis
1666:Hepatic veno-occlusive disease
1488:Solitary rectal ulcer syndrome
663:10.1016/j.thromres.2015.10.016
641:
582:
557:
523:
480:
376:is often first line, however.
230:in the blood being altered by
1:
1873:Sphincter of Oddi dysfunction
570:National Institutes of Health
564:Dugdale, David (2009-11-01).
473:
1782:Postcholecystectomy syndrome
1301:Intestinal pseudoobstruction
909:Esophageal motility disorder
427:
351:
7:
451:
10:
2139:
2118:Digestive disease symptoms
1767:Gallstone / Cholelithiasis
1291:Functional colonic disease
1087:Zollinger–Ellison syndrome
623:; O'Connor, Simon (2014).
380:Melena versus hematochezia
366:tagged red blood cell scan
248:(the active ingredient in
18:
2061:
1940:
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1795:
1752:
1598:
1589:
1542:
1496:
1451:
1337:
1224:
1114:
1101:
976:
968:Acute esophageal necrosis
850:
841:
776:
717:
495:, retrieved 19 July 2010.
263:
196:Gastrointestinal bleeding
178:
168:
152:
135:
126:
118:
113:
1067:Gastric dumping syndrome
942:Laryngopharyngeal reflux
929:Diffuse esophageal spasm
566:"Bloody or tarry stools"
488:MedlinePlus Encyclopedia
29:Meleana (disambiguation)
1683:Alcoholic liver disease
1216:Bile acid malabsorption
1160:Peptic (duodenal) ulcer
341:Melena is considered a
252:), or by foods such as
143:/məˈliːnə/ or /ˈmɛlɪnə/
80:more precise citations.
41:Molina (disambiguation)
37:Milena (disambiguation)
33:Melina (disambiguation)
25:Malina (disambiguation)
21:Malena (disambiguation)
19:For similar terms, see
1693:Hepatic encephalopathy
1077:Buried bumper syndrome
1008:Peptic (gastric) ulcer
892:Mallory–Weiss syndrome
835:human digestive system
530:Navarra, Tova (2004).
493:Bloody or tarry stools
305:Mallory-Weiss syndrome
1918:Pancreatic pseudocyst
1787:Porcelain gallbladder
899:Zenker's diverticulum
301:Meckel's diverticulum
246:bismuth subsalicylate
1722:Hepatorenal syndrome
1661:Budd–Chiari syndrome
1618:Autoimmune hepatitis
1443:Intestinal adhesions
1201:Short bowel syndrome
1030:Functional dyspepsia
948:Esophageal stricture
914:Nutcracker esophagus
416:), for example by a
1861:Choledocholithiasis
1732:Metabolic disorders
1698:Acute liver failure
1671:Portal hypertension
1623:Alcoholic hepatitis
1466:Radiation proctitis
1385:Mesenteric ischemia
1357:Gastroenterocolitis
1186:Blind loop syndrome
996:Ménétrier's disease
904:Barrett's esophagus
651:Thrombosis Research
538:Infobase Publishing
236:intestinal bacteria
174:Dark blood in stool
2036:Undefined location
2027:Grynfeltt–Lesshaft
1928:Pancreatic fistula
1911:Pancreatic abscess
1866:Biliary dyskinesia
1837:Mirizzi's syndrome
1338:Large and/or small
1018:Dieulafoy's lesion
887:Boerhaave syndrome
777:External resources
463:Dieulafoy's lesion
422:ligament of Treitz
297:esophageal varices
260:, or blueberries.
2100:
2099:
2096:
2095:
1936:
1935:
1538:
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1395:Bowel obstruction
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698:978-0-07-174889-6
516:978-0-7020-5103-6
343:medical emergency
232:digestive enzymes
209:
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108:Medical condition
106:
105:
98:
2130:
2088:Pneumoperitoneum
1945:
1944:
1855:Common bile duct
1737:Wilson's disease
1727:Peliosis hepatis
1596:
1595:
1473:Proctalgia fugax
1380:Abdominal angina
1305:Ogilvie syndrome
1254:Pseudomembranous
1112:
1111:
1072:Gastric volvulus
1037:Pyloric stenosis
848:
847:
833:Diseases of the
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595:. Butterworths.
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312:iron supplements
281:thrombocytopenia
242:Iron supplements
163:gastroenterology
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76:this article by
67:inline citations
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2046:Internal hernia
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1842:Biliary fistula
1800:
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1777:Adenomyomatosis
1772:Cholesterolosis
1748:
1742:Hemochromatosis
1613:Viral hepatitis
1585:
1534:
1492:
1478:Rectal prolapse
1447:
1414:Fecal impaction
1404:Intussusception
1367:Crohn's disease
1333:
1316:Toxic megacolon
1228:
1226:Large intestine
1220:
1165:Curling's ulcer
1118:
1116:Small intestine
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1001:Gastroenteritis
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159:General surgery
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122:Melaena, melæna
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72:Please help to
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1552:Blood in stool
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1525:Anal dysplasia
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1390:Angiodysplasia
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1354:
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1325:Diverticulosis
1321:Diverticulitis
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1211:Milroy disease
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1181:Tropical sprue
1178:
1169:
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1103:Lower GI tract
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843:Upper GI tract
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718:Classification
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710:External links
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676:
657:(6): 1074–81.
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608:ulcer disease.
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458:Blood in stool
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432:The origin of
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293:stomach cancer
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216:blood in stool
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1705:Liver abscess
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1688:Liver failure
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1345:Enterocolitis
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1172:Malabsorption
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1047:Gastroparesis
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1038:
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1019:
1016:
1014:
1013:Cushing ulcer
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444:(feminine of
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386:sigmoid colon
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136:Pronunciation
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86:December 2011
79:
75:
69:
68:
62:
57:
48:
47:
42:
38:
34:
30:
26:
22:
2035:
2014:
1891:Pancreatitis
1853:
1803:biliary tree
1676:Nutmeg liver
1653:
1579:Hematochezia
1566:
1530:Pruritus ani
1515:Anal abscess
1510:Anal fistula
1506:Anal fissure
1419:Constipation
1373:
1244:Appendicitis
1052:Gastroptosis
1042:Achlorhydria
881:
870:Eosinophilic
784:
760:
745:
730:
688:
654:
650:
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624:
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591:
584:
573:. Retrieved
559:
551:
532:
525:
506:
500:
486:
482:
445:
441:
440:, via Greek
438:modern Latin
433:
431:
418:peptic ulcer
394:hematochezia
383:
363:
355:
347:
340:
316:Pepto-Bismol
309:
278:
270:peptic ulcer
267:
250:Pepto-Bismol
240:
211:
210:
92:
83:
64:
2071:Peritonitis
1833:Cholestasis
1811:Cholangitis
1754:Gallbladder
1642:Fatty liver
1562:Hematemesis
1544:GI bleeding
1350:Necrotizing
1279:Lymphocytic
1274:Collagenous
1269:Microscopic
1206:Steatorrhea
1107:Enteropathy
953:Inlet patch
875:Herpetiform
860:Esophagitis
786:MedlinePlus
468:Hematemesis
374:Colonoscopy
119:Other names
78:introducing
2107:Categories
2063:Peritoneal
2041:Incisional
1962:Congenital
1906:Hereditary
1883:Pancreatic
1847:Haemobilia
1520:Hemorrhoid
1498:Anal canal
1436:Infectious
1424:Functional
1259:Ulcerative
1143:Duodenitis
1082:Gastrinoma
575:2009-11-30
474:References
448:, black).
285:hemophilia
228:hemoglobin
186:Hemorrhoid
61:references
2051:Richter's
2008:Spigelian
2003:Obturator
1993:Umbilical
1826:Ascending
1797:Bile duct
1630:Cirrhosis
1608:Hepatitis
1591:Accessory
1461:Proctitis
1312:Megacolon
1286:Dysentery
1196:Whipple's
1148:Jejunitis
1138:Enteritis
1025:Dyspepsia
986:Gastritis
919:Achalasia
852:Esophagus
428:Etymology
370:angiogram
352:Diagnosis
328:epistaxis
289:gastritis
258:liquorice
191:Gastritis
154:Specialty
2113:Bleeding
1981:Indirect
1976:Inguinal
1710:Pyogenic
1655:Vascular
1431:Diarrhea
1409:Volvulus
1375:Vascular
1314: /
1303: /
1264:Ischemic
1231:Appendix
1121:Duodenum
991:Atrophic
865:Candidal
671:26508464
452:See also
410:duodenum
274:warfarin
256:, black
254:beetroot
170:Symptoms
2022:Petit's
1998:Femoral
1901:Chronic
1715:Amoebic
1483:Anismus
1249:Colitis
1176:Coeliac
1153:Ileitis
1125:Jejunum
978:Stomach
882:Rupture
767:D008551
442:melaina
406:stomach
404:in the
74:improve
2016:Lumbar
1986:Direct
1969:Hiatus
1949:Hernia
1801:Other
1567:Melena
1453:Rectum
936:(GERD)
791:003130
695:
669:
631:
599:
544:
513:
434:melena
390:rectum
358:anemia
336:Maasai
322:, and
320:Maalox
264:Causes
212:Melena
179:Causes
145:
114:Melena
63:, but
39:, and
2123:Feces
1941:Other
1896:Acute
1647:MASLD
1600:Liver
1574:Lower
1557:Upper
1399:Ileus
1235:Colon
1129:Ileum
944:(LPR)
756:578.1
741:K92.1
446:melas
402:blood
220:feces
1329:SCAD
762:MeSH
751:9-CM
693:ISBN
667:PMID
629:ISBN
597:ISBN
542:ISBN
511:ISBN
388:and
324:lead
303:and
283:and
234:and
1635:PBC
1362:IBD
1296:IBS
747:ICD
732:ICD
659:doi
655:136
408:or
2109::
1799:/
1397::
1378::
1174::
789::
765::
754::
739::
736:10
679:^
665:.
653:.
605:.
568:.
550:.
540:.
536:.
491::
318:,
314:,
307:.
299:,
295:,
291:,
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238:.
161:,
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1229:(
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812:v
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734:-
724:D
701:.
673:.
661::
637:.
578:.
519:.
412:(
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93:(
88:)
84:(
70:.
43:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
