Hematochezia vs Melena: Difference and Comparison

Finding blood in your stool can be frightening and can indicate a serious issue. Here’s what you need to know about the potential causes of bloody stools, Hematochezia and Melena and their main differences.  

Hematochezia is the term for having fresh, crimson blood in your stool, and Melena is the term for having black faeces. Your stool may contain this blood or come out on its own. While Melena originates from a higher location in your GI tract, hematochezia arises from the colon.

Hematochezia and Melena are both symptoms, not diseases. If you find blood in your stool, you should follow up with your doctor right away because some of these disorders are significant.

Key Takeaways

  1. Hematochezia is the passage of bright red blood in stools, while melena refers to black, tarry stools caused by digested blood.
  2. Hematochezia indicates lower gastrointestinal bleeding, whereas melena suggests upper gastrointestinal bleeding.
  3. Hematochezia requires urgent evaluation and treatment, while melena may indicate a slower bleeding rate and less immediate risk.
Hematochezia vs Melena

Hematochezia vs Melena

Hematochezia is the passing of reddish-colored fresh blood with stools, whereas Melena is the passage of black, tarry, and sticky stools as a result of upper gastrointestinal bleeding.

Bleeding might occur when there is an issue or a sickness with your digestive system. As a result, you can vomit blood or have blood come out of your stool. You may notice that your stool is dark. It’s possible for the bleeding to be minor, serious, or even life-threatening. Therefore, getting medical help right away is crucial. 

The methods of treatment vary depending on where the bleeding started. The most common test to find GI bleeding is an endoscopy. Hematochezia and Melena are two signs of GI bleeding. Hematochezia is primarily caused by lower GI bleeding, whereas Melana is primarily caused by upper GI bleeding.

Comparison Table

Parameter of ComparisonHematocheziaMelena
DefinitionFresh blood passing through the stoolPassing of dark-colored vomited blood in the stool
Blood colorBright redBlack
Part of the GI tract involvedMostly lower partMostly upper part
CausesColon problems, bleeding anomaly, inflammatory bowel diseaseEsophagus, and stomach problems, gastritis, cancer
TreatmentSurgeryEndoscopic intravesical cyanoacrylate injection

What is Hematochezia?

Fresh blood passing through the stool is known as hematocele. Hematochezia causes bright crimson blood to appear. Hematochezia is frequently caused by bleeding from the colon or the rectum, two locations in the lower GI tract. 

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Hematochezia is most frequently caused by conditions or issues with the lower GI tract that result in bleeding from the colon, rectum, and anus. Hematochezia must be controlled surgically or through band ligation. 

An upper gastrointestinal source of hematochezia is a concerning symptom since it denotes a large bleeding event that is more likely to be fatal.  Because of inadequate metabolism of a red pigment, eating beetroot can result in beeturia, a harmless condition that can be misdiagnosed as hematochezia. 

The stool and occasionally the urine may turn red or black after eating blackberries or dragon fruit (pitaya). This is also a differentiating symptom that is occasionally confused with hematochezia.

Your lower GI tract may bleed for a number of reasons, such as

  1. Internal haemorrhoids
  2. Diverticular disease, such as diverticulitis
  3. Anal fissures
  4. Colon cancer
  5. Ischemic colitis
  6. Inflammatory bowel disease (IBD)
  7. Neoplastic polyps
  8. Benign tumours

Your doctor will probably begin treating you for hematochezia with a colonoscopy. To do this, a tiny tube with a camera must be inserted through your rectum. 

The tool will allow them to see your colon and lower GI tract so they can determine where the blood is coming from. They might also take a tiny tissue sample for further analysis during the procedure.

What is Melena?

Melena is a condition in which blood that has been digested results in black stools. 

An issue with the upper gastrointestinal system is the cause of bleeding. Melena is frequently brought on by conditions like peptic ulcer, esophageal Mallory-Weiss tears, and liver cirrhosis-related bleeding. 

The initial sign of Melena is the presence of blood in the stool. Later, when the bleeding continues, the person may have dizziness and stomach or blood-related pain. 

Melena can also be caused by gastritis, esophagitis, peptic and duodenal ulcers, and stomach cancer. Because the digestive system’s stomach and small intestine enzymes have partially digested the blood, it appears black in the stool.

How to treat Melena? Melena can be treated surgically or endoscopically with clips or intravesical cyanoacrylate injection. Melena constantly has bleeding coming from her esophagus, stomach, or upper GI tract. 

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Medication may be used to lessen the quantity of acid your stomach generates. If an ulcer is what caused your Melena, the medications might be helpful.  You might also require medication to stop blood flow to an injury or tear.

If your doctor determines that the medications you take are to blame for your Melena, they may need to be changed. The reason for your bleeding may be treated via endoscopy. To stop a rip, your healthcare practitioner could apply heat. To aid in healing, the doctor might clip the tissue together. 

Endoscopic intravesical cyanoacrylate injection or clips may be utilized to halt bleeding in the upper GI tract. Both techniques contain bleeding regions. To prevent shock in cases where a lot of blood has been lost, fluid and blood replacement may be necessary.

Main Differences Between Hematochezia and Melena


  1. The passage of fresh blood per anus, with or without faeces, is referred to as hematochezia.
  2. Hematochezia causes stools to be maroon or red in color.
  3. Hematochezia causes blood to come from the lower GI tract.
  4. Hematochezia can be treated by surgery.
  5. Hematochezia causes colon problems.


  1. Melena describes the discharge of tarry, sticky, and black faeces.
  2. The stools appear to be black because of Melena.
  3. In melena, the upper GI tract is the source of blood.
  4. Melena causes the release of digested blood.
  5. When there is bleeding in the upper GI tract, the blood is partially digested by enzymes, giving the blood the color of melanin when it leaves the body.

Last Updated : 14 October, 2023

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