Black Stools with Blood

Buttock Rectum | Gastroenterology | Black Stools with Blood (Symptom)


Black stool is a condition characterized by very dark or black color feces. In some cases, such as ingestion of substances or medication like iron supplements or consuming food rich in iron a black stool may be normal.


However, black stool can also be caused by a serious condition, such as bleeding in the digestive tract caused by a peptic ulcer. Black stool that is tarry in texture and foul smelling is often a symptom of upper gastrointestinal bleeding from the esophagus, stomach or small intestine. This is called melena.

The most common cause of melena is peptic ulcer disease. Melena may also be a sign of drug overdose if a patient is taking anti-coagulants, such as warfarin. It is also caused by tumors, especially malignant tumors affecting the esophagus, more commonly the stomach and less commonly the small intestine due to their bleeding surface. Other medical causes of melena include bleeding ulcers, gastritis, esophageal varies, and Mallory-Weiss syndrome.

Rectal bleeding of bright red blood with clots, sometimes mixed with stool, is called hematochezia. Hematochezia is often caused by bleeding from the lower digestive tract, including the colon, rectum or anus. Very small amounts of blood in the stool may be seen by the naked eye and does not significantly change the color of stool. This is called fecal occult blood, which can be a symptom of a serious disease and may be found with regular, routine medical testing.

Diagnosis and Treatment

Treatment depends on the cause and severity of the bleeding. For serious bleeding, it may be admitted to a hospital for monitoring and evaluation. If there is massive bleeding, the patient will be monitored in an intensive care unit. Emergency treatment may include a blood transfusion. The following diagnostic tests may be performed: Angiography, Barium studies, Bleeding scan (nuclear medicine), Blood studies, including a complete blood count ( CBC) and differential, serum chemistries, clotting studies, Colonoscopy, Esophagogastroduodenoscopy or EGD, Stool culture, Tests for the presence of Helicobacter pylori infection, X-rays of the abdomen.