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Your doctor will use similar tests to diagnose the underlying cause of melena. This is a more invasive test that involves surgically opening your abdomen to find the source of bleeding. This involves injecting dye into a vein to make blood vessels visible on a CT scan or X-ray. A small amount of radioactive material is injected into a vein while your doctor monitors your blood flow through a camera. This will help your GI tract show up on an X-ray. They might also insert it into your rectum. Your doctor will have you swallow a contrast material called barium. You’ll swallow a small capsule containing a camera that produces images of your GI tract. Other tests used to diagnose the cause of hematochezia include: During the procedure, they may also take a small tissue sample for additional testing. The device will give them a view of your lower GI tract, including your colon, so they can pinpoint where the blood is coming from. This involves inserting a small tube with a camera through your rectum. If you have hematochezia, your doctor will likely start with a colonoscopy. Based on the color of the blood, they’ll do additional testing to narrow down a diagnosis. Your doctor can usually differentiate between melena and hematochezia by simply looking at a stool sample. In addition to melena, you might also experience hematemesis, which refers to vomiting blood. By the time it reaches your anus, it’s been deoxygenated, which removes its bright red color. This blood is darker because it has to travel farther down your GI tract. Your stools might also look or feel sticky.

The blood is usually jet-black, similar to ink from a black ballpoint pen. Melena causes black, tarry stools that are easy to distinguish from the brighter red associated with hematochezia. Other symptoms that might accompany hematochezia include: In addition, hematochezia tends to cause more minor bleeding than melena does. You might notice it mixed in with your stool, though it can also come out separately. The blood only travels a short distance, so it’s still fresh by the time it leaves your anus. Remember, hematochezia is caused by bleeding in your colon, which is fairly close to your anus. Hematochezia is usually a bright red color.