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Hematemesis, Melena, and Hematochezia are three different terms related to blood coming out of the body. Each symptom has its unique causes and presentation. This article will cover the conditions that can cause vomiting blood or blood with stools.

It is awfully scary for a person to see blood coming out of his body, may it be in the form of vomiting, sputum, or with stools. Such an occurrence should not ignored, since symptoms like these may be indicative of certain conditions that are typically known to cause excretion of blood from the body. If left untreated, most of these conditions can be fatal. Knowing the differences between the conditions that may cause bleeding can be helpful in case of an emergency.

The blood is usually seen coming with vomiting or during defecation. Vomiting of blood is known as hematemesis and fresh blood coming with stools is called hematochezia. On the other hand, the passage of black tarry stools is called Melena.

What Is The Difference Between Melena And Hematochezia?

Melena and hematochezia are both related to blood coming along with defecation. However, both of these conditions are totally different from one other.

Melena refers to dark or clotted blood that comes along with stools.

The part of the digestive tract that lies above the small intestine is called the upper gastrointestinal tract. If there is a bleeding in this part of the digestive tract, it either spills out in the form of vomiting, which is called hematemesis, or stays in the digestive tract and is excreted with bowel movements. This results in the clotting of blood within the digestive tract which turns its color black, and explains why patients with upper gastrointestinal bleeding usually present with the complaint of black stools aka melena.

Hematochezia, on the other hand, is the result of bleeding in the lower gastrointestinal tract.

The part of digestive system starting from the large intestine and ending at the anal opening is referred to as lower gastrointestinal tract. Bleeding in any part of the lower gastrointestinal tract will cause the blood to ooze out of the anal sphincter with bowel movements, or even after bowel movements in some cases. This leaking of fresh blood with stools is called hematochezia. In this case, the blood does not stay in the digestive tract for a long time, which is the reason this blood is fresh red in color.

Tests And Diagnosis

Usually, hematochezia is easily diagnosed because anybody can notice fresh blood coming with or after bowel movements. However, in very few cases, the amount of blood is so less that it may go un-noticed. Routine stool examination is the best way to confirm the fact that red blood cells really are coming along with stools. Similarly, hematemesis can easily be diagnosed because the blood is visible to the naked eye.

It must be kept in mind that hematemesis is different from hemoptysis – bloody sputum with coughing. It has been seen that quite a large number of patients consider hemoptysis as hematemesis. Confusing these terms can result in a mistaken diagnosis.

Some conditions can present along with other symptoms like fever, chest pain, and abdominal pain. However, there are a few conditions that solely present with vomiting blood or black stools.

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