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Melena in Children

WHAT YOU NEED TO KNOW:

What is melena?

Melena is blood in your child's bowel movements. This is caused by bleeding in your child's upper gastrointestinal (GI) system or large bowel. Your child's bowel movements may be black or tarry, and have a foul odor. They may also be shiny or sticky.

Digestive Tract

What causes melena?

  • Bleeding from varices in your child's esophagus
  • A duodenal or stomach ulcer
  • Tears or erosion in the lining of your child's esophagus or stomach
  • A tumor in your child's esophagus or stomach
  • Use of medicines such as NSAIDs, aspirin, or blood thinners

How is the cause of melena diagnosed?

Your child's healthcare provider will ask about your child's symptoms. Tell him or her when you or your child first saw blood in your child's bowel movements and the amount you saw. Tell him or her about any recent illness your child had. Include any chronic medical conditions. Foods such as beets, red or purple sports drinks, and certain medicines can look like blood in bowel movements. These are not harmful and do not need to be treated. Tests will be used to find out if your child does have blood in his or her bowel movements:

  • A bowel movement sample will be tested for blood.
  • Blood tests may be used to check your child's oxygen and iron levels. The tests can also show how well your child's blood clots.
  • Endoscopy is a procedure used to examine your child's upper GI. Your child's healthcare provider will use a scope (thin, bendable tube with a light on the end). He or she will move the scope down your child's throat and into his or her stomach. He or she may also take a tissue sample to be tested.
  • CT or x-ray pictures may show the source of the bleeding. The pictures may show a tear, obstruction, or tumor that is causing your child's symptoms.
  • An angiogram is done to look for and stop bleeding from an artery. Contrast liquid is injected into an artery and x-rays of your child's blood flow are taken. Tell a healthcare provider if your child has ever had an allergic reaction to contrast liquid.

How is melena treated?

Treatment will depend on the cause. Your child may need any of the following:

  • Medicine may be given to reduce the amount of acid your child's stomach produces. This may help if your child's melena is caused by an ulcer. Your child may also need medicine to prevent blood flow to an injury or tear.
  • Endoscopy may be used to treat the cause of your child's bleeding. Your child's healthcare provider may use heat to close a tear. He or she may clip tissue together so it can heal. Bands may be placed around bleeding varices to help them stop bleeding.
  • A blood transfusion may be needed if your child loses a large amount of blood.
  • Surgery may be needed if your child has severe bleeding or other treatments do not work. Surgery may be used to fix a tear in the lining of your child's stomach or intestine. Your child may need surgery to remove an obstruction or a tumor.

What can I do to help my child manage or prevent melena?

  • Do not give your child NSAIDs or aspirin. These medicines can cause gastrointestinal bleeding. Talk to your healthcare provider about other pain medicines that are safe for your child to take.
  • Do not let your child have drinks that contain caffeine. Caffeine can irritate your child's stomach. The lining of his or her stomach or intestines may also be damaged.
  • Offer your child a variety of healthy foods. Healthy foods include fruits, vegetables, low-fat dairy products, lean meats, fish, and legumes such as lentils. Healthy foods can help your child heal and improve his or her energy. A dietitian or your child's healthcare provider can help you plan healthy meals and snacks for your child.
  • Have your child drink extra liquids as directed. Liquids can help your child's digestive system work properly. Ask how much liquid your child should drink each day and which liquids are best for him or her.

Call 911 for any of the following:

  • Your child has signs of shock from blood loss, such as the following:
    • Feeling dizzy or faint, or breathing faster than usual
    • Pale, cool, clammy skin
    • A fast pulse, large pupils, or feeling anxious or agitated
    • Nausea or weakness

When should I seek immediate care?

  • Your child continues to have blood in his or her bowel movements after treatment.
  • Your child has severe pain in his or her abdomen.

When should I contact my child's healthcare provider?

  • Your child has new or worsening symptoms.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.