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Medically reviewed by Last updated on May 2, 2022.

What is melena?

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

Digestive Tract

What causes melena?

  • A stomach ulcer
  • Tears in the lining of your esophagus or stomach
  • Bleeding from varices in your esophagus
  • A tumor in your esophagus or stomach
  • Use of medicines such as NSAIDs, aspirin, or blood thinners
  • Radiation or a procedure such as endoscopy that damages your upper GI

How is the cause of melena diagnosed?

Your healthcare provider will ask about your symptoms. Tell him or her when you first saw blood in your bowel movements and the amount you saw. Tell him or her about any recent illness you had. Include any chronic medical conditions. Tell your provider if you recently took NSAIDs or aspirin, and how much you took. 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 you do have blood in your bowel movements:

  • A bowel movement sample will be tested for blood.
  • Blood tests may be used to check your oxygen and iron levels. The tests can also show how well your blood clots.
  • Endoscopy is a procedure used to examine your upper GI. Your healthcare provider will use a scope (thin, bendable tube with a light on the end). He or she will move the scope down your throat and into your 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 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 blood flow are taken. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is melena treated?

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

  • Medicine may be given to reduce the amount of acid your stomach produces. This may help if your melena is caused by an ulcer. You may also need medicine to prevent blood flow to an injury or tear. Your healthcare provider may also make changes to medicines you take if they caused your melena. Examples include NSAIDs and blood thinners. Do not stop taking any medicines without talking to your provider.
  • Endoscopy may be used to treat the cause of your bleeding. Your 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 you lose a large amount of blood.
  • Surgery may be needed if you have severe bleeding or other treatments do not work. Surgery may be used to fix a tear in the lining of your stomach or intestine. You may need surgery to remove an obstruction or a tumor.

What can I do to manage or prevent melena?

  • Do not take NSAIDs or aspirin. These medicines can cause gastrointestinal bleeding. Talk to your healthcare provider about other pain medicines that are safe for you to take.
  • Do not smoke. Nicotine can damage blood vessels. Talk to your healthcare provider if you need help quitting. E-cigarettes or smokeless tobacco still contain nicotine. Ask your healthcare provider for information before you use these products.
  • Do not drink alcohol or caffeine. Alcohol and caffeine can irritate your stomach. The lining of your stomach or intestine may also be damaged. Talk to your healthcare provider if you need help to quit drinking alcohol.
  • Eat 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 you heal and improve your energy.
  • Drink extra liquids as directed. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you.

Call 911 for any of the following:

  • You have 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?

  • You continue to see blood in your bowel movements after treatment.
  • You have severe pain in your abdomen.

When should I contact my healthcare provider?

  • You have new or worsening symptoms.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. 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

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