Melena: Symptoms, Causes, Diagnosis, Treatment and Cost

Melena is a condition that refers to the presence of dark, tarry stools that contain digested blood. The word is derived from the Greek word 'melas,' which denotes darkness. As the blood travels through the digestive system, hemoglobin in the blood breaks down, giving the feces their black color.

Melena is frequently a sign of bleeding in the small or stomach, as well as other parts of the upper gastrointestinal tract. Bleeding can occur for a variety of reasons, including ulcers, tumors, inflammation, and blood vessel abnormalities. The degree of bleeding might be mild or life-threatening, depending on the underlying reason.

There are several types of melena that can occur, depending on the underlying cause of the bleeding. Here are some possible types of melena;

This type of melena occurs when there is bleeding in the upper part of the gastrointestinal tract, such as the stomach or the first part of the small intestine. The blood mixes with stomach acid and digestive enzymes, causing the stool to become black and tarry. Causes of upper gastrointestinal melena may include;

• Peptic ulcers
• Gastritis
• Esophageal varices, often known as upper digestive tract tumors

This kind of melena develops when there is bleeding in the colon or rectum, which are parts of the lower gastrointestinal system. The blood may mix with stool or come out separately, but it will still appear dark and tarry. Causes of lower gastrointestinal melena may include;

• Hemorrhoids
• Diverticulitis
• Inflammatory bowel disease, or cancers of the lower digestive tract

In some cases, melena can be caused by the ingestion of certain foods or substances that can turn the stool black. Examples of substances that can cause ingestion-related melena include;

• Iron supplements
• Black licorice, or bismuth-containing compounds

Ingestion-related melena is usually harmless and will go away on its own once the substance is no longer consumed.

Some medications can also cause melena as a side effect. Examples of medications that can cause melena include;

• Aspirin
• Anticoagulants, or nonsteroidal anti-inflammatory drugs (NSAIDs)

If you are experiencing melena as a side effect of a medication, it is important to talk to your healthcare provider about possible alternatives.

Melena is brought on by the presence of digested blood in the digestive tract. The following are some common causes of Melena;

• Bleeding in the upper gastrointestinal tract, such as the stomach or small intestine
• Peptic ulcers, which may result in bleeding in the duodenum or stomach
• Esophageal varices are enlarged veins that can rupture and hemorrhage in the esophagus
• Mallory-Weiss tears, which are esophageal lining tears that can happen as a result of vomiting or retching
• Aspirin and nonsteroidal anti-inflammatory medicines are some examples of pharmaceuticals (NSAIDs)
• Cancerous or noncancerous growths in the digestive tract

Melena is characterized by the appearance of dark, tarry stools that can have a distinct smell. Other symptoms of Melena include;

• Pain or discomfort in the abdomen
• Nausea or vomiting
• Weakness or fatigue
• Shortness of breath

Certain factors or triggers can bring on Melena or exacerbate its symptoms. Some common triggers include;

• Certain foods, such as iron supplements or foods that are high in iron
• Alcohol consumption
• Stress or anxiety
• Physical exertion or strenuous exercise
• NSAIDs and other medications that may irritate the stomach

No matter their age or gender, everyone can be affected by melana. However, older persons and people with underlying illnesses such as gastritis, gastrointestinal ulcers, and colorectal cancer are more likely to experience it. Melena is a symptom of a gastrointestinal tract issue rather than an illness or ailment in and of itself.

If untreated, melana can be a dangerous condition. It typically denotes bleeding in the small intestine or stomach, which are parts of the upper gastrointestinal tract. This can be caused by a number of underlying conditions such as ulcers, tumors, or inflammatory bowel disease. If the bleeding is severe or goes on for an extended period of time, it can lead to anemia, hypovolemia, and shock.

Anemia is the body’s inability to transport oxygen to the tissues due to the low count of red blood cells. Shortness of breath, weakness, and exhaustion may result from this.

Hypovolemia is a condition in which the body loses too much fluid and blood volume, leading to a drop in blood pressure and decreased oxygen delivery to the tissues. In severe cases, hypovolemia can cause shock, which can be life-threatening.

Underlying conditions such as gastrointestinal ulcers, gastritis, or colorectal cancer can also manifest as Melena, in addition to the immediate complications it can cause. These conditions can lead to a range of complications, including perforation of the intestinal wall, intestinal obstruction, and severe infection. These conditions can be fatal if left untreated.

Melena risk can be raised by a number of factors, which may include;

• Age (Melena is more common in older adults)
• Previous history of gastrointestinal bleeding
• Chronic kidney disease
• Chronic liver disease
• Blood clotting disorders
• Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs)

Prevention of Melena depends on addressing its underlying causes. However, some general steps that can reduce the risk of Melena include;

• Avoiding triggers that can cause or exacerbate Melena, such as certain foods, alcohol, or medications
• Eating a healthy diet rich in fiber and low in fat
• Managing stress and anxiety
• Taking medications as prescribed and under the supervision of a healthcare provider
• Getting regular check-ups and screenings to detect any underlying medical issues early

Melena is a symptom of an underlying condition and it is important to diagnose the root cause in order to provide appropriate treatment. Typically, a medical history, physical examination, and a number of diagnostic procedures are used to diagnose Melena.

Here are the various diagnostic procedures and tests that are commonly used to diagnose Melena;

• Medical history: A detailed medical history of the patient is taken to identify any previous gastrointestinal conditions, surgeries, or medications. It is important to inform the doctor about any other symptoms such as abdominal pain, nausea, vomiting, or changes in bowel habits.
• Physical examination: The goal of a physical examination is to determine the patient's general health and check for any indications of bleeding or other problems. This may involve a visual examination of the rectum and anus, as well as an abdominal exam to check for tenderness, distention, or masses.
• Stool test: The presence of blood in the feces is frequently confirmed by a stool test. This may involve a simple fecal occult blood test (FOBT) or a more sensitive test such as a fecal immunochemical test (FIT).
• Endoscopy: During an endoscopy, a flexible tube with a camera on the end is introduced into the digestive tract to check for any anomalies. An upper gastrointestinal endoscopy (UGIE) or a colonoscopy may be performed to identify the location and cause of the bleeding.
• Imaging tests: A CT scan, MRI, or ultrasound can be performed to examine the internal organs and find any anomalies that might be the source of the Melena.
• Blood tests: Blood tests can be used to look for any abnormalities that might be causing the Melena, such as anemia, clotting issues, or other conditions.

Melena, which is characterized by tarry, dark feces, may indicate serious underlying medical issues. If ignored, it can lead to a variety of significant issues, some of which may be fatal. Here are some potential Melena side effects that could occur;

• Anemia (due to loss of blood)
• Shock (due to severe blood loss)
• Dehydration (due to excessive fluid loss)
• Malnutrition (due to poor absorption of nutrients in the digestive tract)
• Perforation (rupture) of the digestive tract

There are no specific home remedies for Melena, and it is important to seek medical attention immediately if you experience any symptoms. However, some general steps that can help manage Melena symptoms include;

• Drinking plenty of fluids to avoid dehydration: Melena can cause dehydration due to the loss of blood in the stools. To assist restore lost fluids and prevent dehydration, it is crucial to consume lots of liquids. Water is the best fluid to drink, but you can also drink other clear liquids such as broth, fruit juice, or sports drinks to help replace lost electrolytes.
• Resting and avoiding physical exertion: Resting and avoiding physical exertion can help reduce the risk of further bleeding and promote healing. It is important to avoid strenuous activities that can put stress on the body, such as heavy lifting or high-intensity exercise.
• Eating a healthy, balanced diet to promote healing and recovery: Eating a healthy, balanced diet can help promote healing and recovery after an episode of Melena. Lean proteins, whole grains, a range of fresh fruits and vegetables, and low-fat dairy foods should all be a part of a balanced diet. It might also be advantageous to stay away from caffeine, alcohol, spicy food, high-fat food, and processed food.
• Avoiding triggers that can cause or exacerbate Melena: Certain foods, medications, and activities can trigger or exacerbate Melena. To prevent further episodes, it's imperative to be aware of and avoid these triggers. Nonsteroidal anti-inflammatory medicines (NSAIDs), including aspirin and ibuprofen, alcohol, caffeine, spicy or fatty foods, and stress are examples of common triggers.

It is crucial to remember that while these natural treatments for Melena may help lessen its symptoms, they are not a replacement for medical care.

When experiencing Melena, it's crucial to consume a healthy, balanced diet to encourage healing and recovery. Some recommended foods include;

• Lean proteins, such as chicken, fish, or tofu
• Fresh fruits and vegetables
• Whole grains
• Low-fat dairy products

Some foods and drinks can irritate the digestive tract and should be avoided when experiencing Melena. These include;

• Spicy or fatty foods
• Alcohol
• Caffeine
• Carbonated drinks
• Acidic foods, such as citrus fruits or tomatoes

Melena can be a sign of various underlying conditions, and treatment for Melena depends on the underlying cause. The main objectives of treatment are typically to stop the bleeding and improve the patient's general health.

Here are the various treatment options that are commonly used to manage Melena;

• Medications: Depending on the underlying cause of Melena, medications may be prescribed to manage the condition. For example, proton pump inhibitors may be prescribed to treat ulcers, or antibiotics may be prescribed to treat infections.
• Endoscopic therapy: Endoscopic therapy may be used to stop active bleeding and prevent re-bleeding in certain cases. This may involve injecting medications or using thermal or mechanical devices to stop the bleeding.
• Surgery: Surgery could occasionally be required to address the underlying causes of Melena. This can entail cutting a section of the intestine out or fixing broken blood vessels.
• Blood transfusions: If the patient has lost a significant amount of blood due to Melena, blood transfusions may be necessary to restore blood volume and prevent complications.
• Iron supplements: Patients with Melena may develop iron deficiency anemia, which can be treated with iron supplements to improve the body's production of red blood cells.

To manage Melena, lifestyle changes may also be suggested in addition to these therapeutic choices. These may include avoiding alcohol and non-steroidal anti-inflammatory drugs (NSAIDs), following a healthy diet, and staying hydrated.

You should gastroenterologist a doctor who specializes in digestive diseases if you are suffering Melena symptoms. A gastroenterologist is a medical professional who focuses on identifying and treating diseases that affect the stomach, intestines, liver, and pancreas.

In addition to gastroenterologists, other healthcare professionals who may be involved in the diagnosis and treatment of Melena include primary care physicians, internal medicine specialists, and surgeons. Depending on the severity and underlying cause of the condition, these healthcare professionals may collaborate to develop a comprehensive treatment plan.

Melena is a symptom of an underlying condition and the treatment options depend on the specific cause of the Melena. The choice of therapy will therefore be determined by the underlying condition that is generating the Melena. Here are some of the common medications that may be prescribed to treat the underlying causes of Melena;

• Proton pump inhibitors: These medications, such as omeprazole and pantoprazole, are commonly used to treat gastric and duodenal ulcers. They function by lowering the level of stomach acid production, which can help to promote healing and prevent further bleeding.
• Antibiotics: If Melena is caused by an infection, such as Helicobacter pylori, antibiotics may be prescribed to treat the infection and prevent further bleeding.
• H2 blockers: These medications, such as ranitidine and famotidine, are used to treat ulcers and prevent acid reflux. They work by reducing the amount of acid produced by the stomach.
• Antacids: These drugs, which include magnesium hydroxide and aluminum hydroxide, neutralize stomach acid and relieve heartburn and other acid reflux symptoms.
• Iron supplements: If Melena is causing iron deficiency anemia, iron supplements may be prescribed to restore iron levels and improve the body's production of red blood cells.

The underlying cause and the degree of the bleeding can both affect how long it takes to recover from Melena. Melena can sometimes go away on its own, but there are other times when it may need medical attention.

For example, if the Melena is caused by a minor irritation in the digestive tract, such as a small tear in the lining of the stomach or esophagus, it may heal on its own within a few days to a week. However, if the Melena is caused by a more serious condition, such as a gastrointestinal ulcer or cancer, the recovery time may be longer and require more aggressive treatment.

It is important to follow the treatment plan prescribed by a healthcare professional, which may include medication, dietary changes, and lifestyle modifications, in order to help speed up the recovery process. Additionally, it is important to attend all follow-up appointments and screenings to monitor progress and ensure that the Melena does not recur.

The underlying cause of the Melena will have an impact on how long the treatment's effects last. If the Melena is caused by a treatable condition, such as an infection or ulcer, and the underlying condition is effectively treated, the Melena may not recur.

However, if the Melena is caused by a more serious condition, such as colorectal cancer, long-term monitoring and treatment may be necessary to prevent the recurrence or progression of the disease. Creating a long-term management strategy for any underlying problems that might be the cause of Melena necessitates close collaboration with a healthcare practitioner.

After receiving treatment for Melena, it is important to follow certain post-treatment guidelines to promote healing and prevent a recurrence of the condition. These guidelines may include lifestyle modifications, dietary changes, and monitoring for any potential complications;

1. Taking medications as prescribed: Depending on the underlying cause of Melena, you may be prescribed medications to treat the condition or prevent future episodes. It is important to take these medications exactly as prescribed by your healthcare provider, including the correct dosage and frequency. If you have any questions or concerns about your medicines, consult your doctor.
2. Following a healthy, balanced diet: Eating a healthy, balanced diet is important for overall health and can also help promote healing and prevent future episodes of Melena. Some general tips for following a healthy, balanced diet include;
3. Consuming a mix of fresh fruits and vegetables, whole grains, lean proteins, and low-fat dairy products is one way to maintain a healthy, balanced diet, Avoiding foods that are high in saturated and trans fats, added sugars, and sodium, Drinking plenty of water to stay hydrated, Limiting or avoiding alcohol and caffeine, as these can irritate the digestive tract
4. Avoiding triggers that can cause or exacerbate Melena: Certain foods, medications, and activities can trigger or exacerbate Melena. In order to prevent additional episodes, it is essential to be aware of and avoid certain triggers. Common triggers include;
   • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
   • Alcohol and caffeine
   • Spicy or fatty foods
   • Tobacco use
   • Stress and anxiety

5. Getting regular check-ups and screenings: Frequent checkups and screenings can aid in identifying and treating hidden medical conditions that may be causing Melena. Your healthcare provider may recommend regular screenings for conditions such as colon cancer or stomach ulcers, especially if you have a family history of these conditions or other risk factors. It is important to attend all scheduled appointments and screenings and to report any new or unusual symptoms to your healthcare provider.

Many variables, including the underlying cause of Melena, the severity of the ailment, and the kind of treatment needed, might affect the cost of Melena therapies in India. The cost can also vary depending on the hospital or healthcare facility chosen, as well as the region or city where the treatment is being sought.

For instance, depending on the medicine type and length of therapy needed, the price of medications used to treat Melena might range from a few hundred to several thousand rupees. In addition to medication costs, diagnostic tests, hospitalization, and other medical expenses may also need to be taken into consideration.

It is important to consult with a healthcare professional to determine the most appropriate treatment plan for Melena, as well as to get an estimate of the associated costs. Many hospitals and healthcare facilities in India offer cost-effective treatment options and may provide financial assistance or payment plans for those who need it.

Depending on the underlying reason and the chosen treatment strategy, the specific side effects of Melena therapies can change. Some general side effects of Melena treatments may include;

• Nausea or vomiting
• Abdominal pain or discomfort
• Diarrhea or constipation
• Dizziness or lightheadedness
• Allergic reactions (in rare cases)

The outlook and prognosis for Melena rely on a number of variables, including the ailment's underlying etiology, the degree of bleeding, and how quickly the condition is identified and treated. If Melena is caused by a minor condition such as a bleeding ulcer or hemorrhoids, the prognosis is generally good and the condition can be easily treated. However, if Melena is caused by a more serious condition such as colorectal cancer or inflammatory bowel disease, the prognosis may be more guarded and the treatment may be more complex.

In general, early diagnosis and treatment are crucial for a positive prognosis. With prompt medical attention and appropriate treatment, the majority of individuals with Melena can recover and return to their normal activities. However, if left untreated or if there is a delay in diagnosis, the condition can potentially lead to more serious complications or even be life-threatening.

It is important to follow post-treatment guidelines and continue to monitor for any potential complications after being treated for Melena. In order to identify any reoccurring or newly discovered gastrointestinal disorders, routine checkups and screenings may be advised. By taking a proactive approach to managing the condition, individuals with Melena can improve their outlook and maintain good health.