In plain words
Melena is stool that is black, tarry, and sticky, often with a strong smell. It usually means blood from higher in the digestive tract has been digested on its way out. Pregnancy can bring constipation and hemorrhoids, which cause different signs, usually bright red blood. Iron pills can darken stool, but the stool is not usually sticky or tarry. Melena is a reason to call your provider the same day. If it comes with dizziness, , a racing heartbeat, or heavy bleeding, call 911 now. Tell your provider about any new black stool, even if you think food or supplements caused it.
The deeper version
Melena is melanotic stool containing digested blood, most often from an upper gastrointestinal source. Hematochezia, by contrast, suggests a lower or faster source. Upper GI bleeding is uncommon in pregnancy but significant, with causes including peptic ulcer disease, esophagitis, and variceal bleeding, and with and severe vomiting as contributing conditions. The American College of Gastroenterology guideline on upper GI and ulcer bleeding (Laine et al., 2021) describes risk assessment, resuscitation, and endoscopic management. Evaluation includes hemodynamic status, trend, and endoscopy. The controversy is how to apply endoscopy timing and risk tools in pregnancy, where data are limited.
Where it comes up
- Gut health before and during pregnancyBefore Pregnancy
- Heartburn and refluxPregnancy: Your Body
- Constipation and hemorrhoids in pregnancyPregnancy: Your Body
- The first poop, constipation, and hemorrhoids after birthPostpartum: Your Body
What mothers here say about melena
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Sources
- Laine L et al., American College of Gastroenterology — ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding (2021)