Stools - bloody; Melena; Stools - black or tarry; Upper gastrointestinal bleeding; Melenic stools
Black or tarry stools with a foul smell are a sign of a problem in the upper digestive tract. It most often indicates that there is bleeding in the esophagus, stomach, or first part of the small intestine.
The term melena is used to describe this finding.
Eating black licorice, blueberries, blood sausage or taking iron pills, activated charcoal, or medicines that contain bismuth (such as Pepto-Bismol), can also cause black stools. Beets and foods with red coloring can sometimes make stools appear reddish. In all these cases, your health care provider can test the stool with a chemical to check for the presence of blood.
Bleeding in the esophagus or stomach (such as with peptic ulcer disease) can also cause you to vomit blood.
The color of the blood in the stools can indicate the source of bleeding.
Peptic ulcers are the most common cause of acute upper GI bleeding. Black and tarry stools may also occur due to:
Contact your health care provider right away if:
In children, a small amount of blood in the stool is most often not serious. The most common cause is constipation. You should still tell your child's provider if you notice this problem.
Your provider will take a medical history and perform a physical exam. The exam will focus on your abdomen.
You may be asked the following questions:
You may need to have one or more tests to look for the cause:
Severe cases of bleeding that cause excessive blood loss and a drop in blood pressure may require surgery or hospitalization.
DeGeorge LM, Nable JV. Gastrointestinal bleeding. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 26.
Kovacs TO, Jensen DM. Gastrointestinal hemorrhage. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 121.
Savides TJ, Jensen DM. Gastrointestinal bleeding. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 20.
BACK TO TOPReview Date: 6/11/2024
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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06/01/2025
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