Black and Tarry (Melena): What to Do If You Think Your Poop Is Melena

Noticing black, sticky stools can be unsettling. In medical terms, this type of stool is called melena—digested blood that turns stool black and tar-like. While not every instance of dark stool is dangerous, melena often signals bleeding in the upper gastrointestinal (GI) tract. This guide will help you understand possible causes, what to look for, and when to get medical help.

What Is Melena?

• Melena describes stools that are

  • Black in color
  • Sticky or tar-like in consistency
  • Foul-smelling

• Why stool turns black and tarry

  • Blood from the esophagus, stomach or small intestine mixes with digestive enzymes
  • Iron supplements or certain foods (e.g., black licorice, blueberries) can also darken stool

If you’re unsure whether your stool is dark because of food or melena, read on.

Common Causes of Black and Tarry Stool

1. Gastrointestinal bleeding

   • Peptic ulcers (sores in the stomach lining)
   • Gastritis (inflammation of the stomach lining)
   • Esophageal varices (swollen veins in the esophagus)
   • Mallory-Weiss tears (small tears in the esophagus)

2. Medications and supplements

   • Iron supplements
   • Bismuth subsalicylate (Pepto-Bismol)
   • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen

3. Foods and dyes

   • Black licorice, blueberries, or foods with dark food coloring

4. Other causes

   • Swallowed blood (for example, after dental work or a nosebleed)
   • Certain infections or inflammatory conditions

Signs That Suggest True Melena

Not every black stool is melena. Look for these accompanying signs:

• General symptoms

  • Weakness or lightheadedness
  • Unexplained fatigue

• GI-related symptoms

  • Abdominal pain or cramping
  • Nausea or vomiting (sometimes with blood)
  • Heartburn or indigestion

• Bleeding-related symptoms

  • Rapid heart rate
  • Low blood pressure (feeling faint when you stand up)
  • Pale skin

If you see any of these signs, it’s time to pay closer attention.

What To Do Right Now

1. Take note of your stool

   • Color: true melena is jet black
   • Consistency: sticky, tar-like, foul odor
   • Frequency: how many times you’ve passed it in the last 24–48 hours

2. Check for other symptoms

   • Dizziness, weakness, fast heartbeat
   • Abdominal pain, nausea, vomiting

3. Review recent diet and meds

   • Did you eat foods that can darken stool?
   • Have you started iron or bismuth-based meds recently?

4. Do a free, online symptom check

   • Try a free, online symptom check, using the doctor approved Ubie Symptom Checker to get personalized guidance and decide if you need to seek in-person care.

When to Seek Immediate Medical Attention

Melena usually means bleeding somewhere in the upper GI tract. You should go to an emergency department or call emergency services if you experience:

• Large amounts of black, tarry stool
• Signs of severe bleeding:
  • Vomiting blood or “coffee grounds” in vomit
  • Fainting, chest pain or severe lightheadedness
• Rapid heartbeat or confusion
• Very low blood pressure (feel faint standing up)

These could be life-threatening emergencies such as a bleeding ulcer or esophageal tear.

Scheduling an Urgent Doctor Visit

If you have milder symptoms but still suspect melena, contact your primary care provider or a gastroenterologist within 24 hours:

• Describe your stool color, consistency, and any other symptoms
• Provide information on recent medications, supplements, and diet
• Ask if you need lab tests (e.g., complete blood count) or imaging (e.g., endoscopy)

What to Expect at the Doctor’s Office

Your doctor will likely:

1. Take a detailed history

   • Onset and duration of black stools
   • Medications, diet, alcohol use

2. Perform a physical exam

   • Check vital signs (blood pressure, heart rate)
   • Look for signs of anemia (pale skin) or abdominal tenderness

3. Order diagnostic tests

   • Complete blood count (to check for anemia)
   • Fecal occult blood test (to confirm blood in stool)
   • Endoscopy (to visualize and possibly treat bleeding)

4. Treat the underlying cause

   • Medications to reduce stomach acid (proton pump inhibitors)
   • Endoscopic procedures to stop bleeding
   • Antibiotics if an infection (e.g., H. pylori) is found

Home Care and Monitoring

While waiting for your appointment or after initial treatment, you can:

• Stay hydrated

  • Drink water, clear broths or electrolyte solutions

• Adjust your diet

  • Avoid spicy foods, caffeine and alcohol
  • Eat small, bland meals (rice, bananas, toast)

• Avoid NSAIDs and other irritants

  • Switch to acetaminophen for pain relief if approved by your doctor

• Keep a stool diary

  • Note the date, appearance and any associated symptoms

Preventing Future Episodes

Once your doctor identifies the cause of melena, you can often prevent recurrences by:

• Treating ulcers or gastritis as directed
• Avoiding long-term NSAID use (ask your doctor for alternatives)
• Limiting alcohol and tobacco
• Managing stress and eating a balanced diet

Key Takeaways

• Melena is black, tarry stool that often means upper GI bleeding.
• Not all dark stools are melena—iron supplements and certain foods can mimic it.
• Look for accompanying symptoms: dizziness, abdominal pain, vomiting.
• Use a free, online symptom check, using the doctor approved Ubie Symptom Checker for quick guidance.
• Seek emergency care for large bleeds, severe weakness or fainting.
• Schedule an urgent doctor visit if you have milder symptoms or ongoing concerns.
• Treatment may involve medication, endoscopic procedures, or lifestyle changes.
• Always follow up with your healthcare provider and keep a stool diary.

If you ever feel that your symptoms could be life-threatening or you’re unsure what’s happening, speak to a doctor right away. Early evaluation and treatment can make all the difference.