Melena is black or dark stools due to bleeding in the ducts cerna top . Melena can become an emergency condition if bleeding occurs by suddenly dnumber nature a lot, up to cause shock.
Melena occurs when there is bleeding in one of the organs of the upper digestive tract, namely the esophagus, stomach, and duodenum. Most of the causes of bleeding in the upper digestive tract are ulcers or ulcers in the stomach. Another common cause is the rupture of varicose veins or widening of the veins in the esophagus. esophagus ).
Melena treatment steps can be in the form of drug administration, as well as endoscopic or surgical procedures. This treatment aims to improve the patient's condition and stop bleeding.
Symptoms of Melena
Melena is stool that is dark or black in color due to upper gastrointestinal bleeding. In addition to being dark in color, upper gastrointestinal bleeding will make stools more sticky or thick, and smell bad.
In addition to bloody stools, other symptoms that can accompany upper gastrointestinal bleeding are:
- Vomiting that looks like coffee (vomiting blood)
- Pain in the stomach
When to go to the doctor
When you see dark or black stools, see a doctor immediately. Changes in the color of the stool may indicate digestive tract bleeding, so it is necessary to immediately identify the cause so that the bleeding can be controlled.
Heavy bleeding in the digestive tract can make the sufferer go into shock, which is indicated by:
- Dizzy
- Lightly
- A cold sweat
- Urine becomes less
- Heart beat
- Hard to breathe
- Unconscious.
These conditions include emergency conditions. Patients need to get medical help as soon as possible.
Cause of Melena
The cause of melena is upper gastrointestinal bleeding. Upper gastrointestinal bleeding can be caused by:
Ulcer gastric and duodenal ulcers
Gastric ulcers are sores that occur in the stomach wall, while duodenal ulcers are sores on the duodenum. This wound can be caused by a bacterial infection H. pylori or long-term use of non-steroidal anti-inflammatory drugs.
Tear in the wall of the esophagus
This condition is called Mallory-Weis syndrome and is more common in alcoholics. These tears can cause heavy bleeding.
Rupture of v arises in the esophagus
Rupture of varicose veins in the esophagus (esophageal varices) occurs in patients with cirrhosis. Varicose veins are dilated veins that are prone to tearing and bleeding.
Esophageal inflammation (esophagitis)
Inflammation of the esophagus can be experienced by people with gastric acid reflux disease (GERD). Stomach acid that rises into the esophagus can cause inflammation and damage to the esophageal tissue, resulting in bleeding.
In addition, melena can also be caused by esophageal cancer (esophagus) or stomach cancer. Medical procedures, such as endoscopy or radiotherapy, can also cause upper gastrointestinal bleeding, leading to complaints of melena.
Melena's Diagnosis
The doctor will take steps to make sure the patient has melena or not, including a digital rectal examination. After a physical examination, the doctor will perform a complete blood count and take a stool sample to confirm any bleeding.
In addition, an endoscopic examination will be performed by a gastroenterologist to see the condition of the upper digestive tract. This examination aims to find the source of bleeding, so that appropriate action can be determined to stop the bleeding.
If the bleeding occurs suddenly and profusely to the point of shock, the doctor can rule out the diagnosis process and stabilize the patient's condition first, by giving intravenous fluids to CPR.
Doctors can also perform surgery to find the source of bleeding, if the source of bleeding cannot be found by endoscopic examination. Surgery is performed at once to stop the bleeding.
Melena Handling
Melena treatment aims to stop the bleeding and treat the cause of the bleeding. Rapid and profuse bleeding can cause shock which can be fatal.
This condition is an emergency condition, which needs to be treated immediately. Doctors will try to stabilize the patient's condition in shock by giving intravenous fluids or blood transfusions to replace lost blood. Endoscopic action or surgery can also be done immediately to find and stop the source of bleeding.
In non-emergency conditions, the treatment for melena is to:
Drug-o bat
In the case of melena due to peptic ulcer, gastric acid production needs to be reduced by giving proton pump inhibitor drugs, for example pantoprazole. Initially, this drug will be given through intravenous fluids. After the bleeding is resolved, the doctor can give this drug in tablet form.
If the bleeding is caused by taking non-steroidal anti-inflammatory drugs or because of blood thinners, the patient will be advised to stop taking these drugs.
endoscope
An endoscopic procedure is performed in order to find the source of the bleeding and stop it. With the help of an endoscope, bleeding can be stopped in the following ways:
- Clamping blood vesselsThis procedure can close blood vessels or other tissues that are the source of bleeding in the upper gastrointestinal tract.
- Injectrightspecial liquidThe injected fluid is used to stop bleeding.
- Warms up blood vesselsThis action is done by burning the blood vessel or tissue that is injured (ulcer), so that bleeding in that place can stop.
Embolization
This procedure is performed by a radiology doctor with a special area of expertise, namely interventional radiology. Embolization is done by injecting a special substance to close a leaking or ruptured blood vessel. To find the location of bleeding, it is necessary to scan with X-rays.
Operation
Surgery is required in cases of melena where the source of the bleeding is not found or when other treatment efforts have not succeeded in controlling the bleeding. Surgery can also be done to remove and repair the torn stomach or intestine wall, so that bleeding can stop.
Melena Prevention
Melena can be prevented by avoiding various causes of gastrointestinal bleeding. Efforts that can be made include:
- Limiting consumption of non-steroidal anti-inflammatory drugs (NSAIDs), caffeine, and
- Quit smoking.
- Eat a balanced diet and drink lots of water.