What medical tests will I have to diagnose melena?

If your healthcare provider suspects you have melena, they’ll start by testing your stool. A fecal occult blood test can determine if there’s blood in your stool that you can’t clearly see. But diagnosing melena is just the beginning. Your provider will then need to diagnose and address the cause of your bleeding.

Tests may include:

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Treatment for melena involves:

Treating your blood loss.

Stopping the bleeding.

Treating the cause of the bleeding.

Your healthcare provider will assess your overall condition to determine the treatment you need. Depending on how much blood you’ve lost, you may need IV fluids or a blood transfusion to restore your blood volume. Some people may even need intensive care before further testing or treatment.

Your provider can often stop active bleeding and prevent new bleeding with endoscopic therapies. During an upper endoscopy, they might seal the wound with electrocautery or by injecting medication into it. Sometimes, they place a clip or band on the blood vessel. Sometimes, stitches are needed.

Acid-blocking medications called proton pump inhibitors (PPIs) are often prescribed for ulcers, inflammation or erosion in your gastrointestinal lining. They promote healing and help protect the tissues from chemical damage. Some of the causes of melena will need more comprehensive treatment.