Black stools are often caused by digested blood. Bleeding due to any health problem in the upper gastrointestinal tract causes black stools called melena. A small amount of bleeding may not cause a noticeable color change in stool. This can only be noticed in stool tests, where the stool sample is examined. In contrast to this condition, also known as fecal occult blood, melena has a distinctly black color. The black stool, which is seen due to heavy bleeding with acute onset, can be easily noticed by the patient. In such a case, since serious blood loss may occur, the necessary health checks should be made by applying to health institutions as soon as possible.
What is Melena?
Melena; It is the name given to unusual, foul-smelling stools that have a tar-like black color. “What does Melena mean?” In other words, the question can be answered as black stool. The black color in question is caused by blood flowing into the digestive cavity as a result of bleeding in the upper gastrointestinal tract. As a result of the digestion of blood in the digestive system by stomach acid and intestinal enzymes, it acquires a sticky character like pitch and black. The majority of bleeding that leads to melena is from the esophagus (oesophagus) and stomach. In addition, bleeding originating from the upper parts of the small and large intestines can also cause melena. In bleeding in the lower parts of the digestive system, the blood in the stool becomes cherry-bruised or red, bright-colored because the blood is not sufficiently exposed to enzymes. This picture, which is called blood in the stool, can be seen in the anal region; hemorrhoids and anal fissure in the large intestine; It can be caused by different diseases such as ulcers, cancer and polyps.
What Causes Black Stool?
Many different diseases that can cause bleeding in the upper parts of the gastrointestinal tract can be counted among the causes of black stools. People who have encountered such a problem for the first time, who have not been diagnosed with any digestive system disease before, ask, "Why does the stool turn black?", "Why does black stool occur?" He often seeks answers to questions such as: It can cause stool to be black in color. Some of the additional conditions can be listed as follows:
- Esophageal Varices: In some cases, such as cirrhosis, the enlargement of the veins in the esophagus can lead to esophageal varices. When there is a rupture in these enlarged vessels, serious bleeding may occur. Since the blood flowing into the esophagus will be excreted through the stool, it causes black stools. In addition to stool, the possibility of bloody vomiting (Hematemesis) caused by blood excreted through the mouth is quite high.
- Gastritis: Inflammation that occurs in the layer covering the inner surface of the stomach is called gastritis. Acute or chronic gastritis, which can be caused by smoking and alcohol use, infection caused by the bacterium Helicobacter Pylori, eating unhealthy and excessively spicy foods, can cause bleeding in the stomach by causing mucosal damage. In this case, it is possible to have a black-colored stool problem.
- Stomach Ulcer: Gastric ulcers, also called peptic ulcers, are sores that form on the inner surface of the stomach. Although the most common cause is the infection of the bacterium Helicobacter Pylori, which also causes gastritis, stomach ulcers that develop due to different reasons can cause serious bleeding if left untreated. This situation brings melena along. Melena is an important finding in this type of bleeding.
- Various Drugs: Non-steroidal (non-steroidal) anti-inflammatory drugs, which are frequently used as painkillers and anti-inflammatory agents, increase the tendency of bleeding in the body. In the same way, drugs called blood thinners, anticoagulants or anticoagulants also increase the bleeding tendency. As a result of these, especially in individuals with diseases such as gastritis and stomach ulcer, as a result of long-term use of non-steroidal inflammatory drugs or anticoagulant drugs, Inal bleeding may occur, additionally, black color may be observed in the stool. If such a situation occurs, the doctor should be consulted immediately, as the drug may need to be discontinued.
- Gastrointestinal System Cancers: Tumors in the digestive system are another important cause of gastrointestinal system bleeding. Especially in the initial part of the intestines, esophagus and stomach tumors, it is possible to see black color in the stool in case of bleeding. This is due to the baby swallowing the mother's blood during delivery. This situation, which usually heals within a few days, should be consulted if it persists for a longer period of time.
Which doctor to go to if the stool is black?
Black colored It is recommended that people who see that they have stool problems should apply to health institutions and go through control. In such a case, many people wonder which doctor should be consulted. People with melena complaints should apply to gastroenterology specialists serving in the gastroenterology polyclinics of hospitals.
In case the gastroenterology specialist cannot be reached, it is possible to apply to the internal medicine (internal diseases) polyclinics to undergo the examination by having tests such as blood test and stool test required for preliminary diagnosis. First of all, a detailed medical history is taken from the patients who apply to the health institution. Various diagnostic tests are applied after obtaining information such as how long the bleeding has been going on, whether there are different problems such as diarrhea and vomiting, and if there are drugs used, what they are. Routine blood tests, arterial blood gas measurement, liver function tests are performed to investigate the cause of bleeding. In addition, stool test is performed to determine whether black stool is caused by bleeding. Gastrointestinal bleeding that continues for a long time usually causes a decrease in hemoglobin and hematocrit levels, resulting in anemia. By examining these parameters in blood tests, it can be determined whether the bleeding is acute or chronic. In addition, endoscopy The location and exact cause of bleeding can be determined by imaging the esophagus, stomach, small and large intestines with traditional methods. In the meantime, tissue samples obtained by biopsy from problem areas can be sent to pathology units for examination under laboratory conditions. Examinations such as computed tomography performed by administering IV (intravenous) contrast material are among the screening methods that can be applied depending on the patient's condition.
After all these procedures, the cause of black stool can be determined exactly. If there is bleeding, its location and cause can be diagnosed exactly. After diagnosis of the disease causing melena, a focus-oriented treatment plan is created. With the treatment, it is possible to eliminate the bleeding and return the stool to normal color, and also to treat other problems caused by bleeding. In the event of a possible bleeding, you can prevent health problems due to blood loss by getting your treatment in the early period.
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