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Melaena is defined as the passage of dark-coloured faeces stained with blood pigments or with altered blood. Melaena usually indicates upper gastrointestinal (GI) disease, as opposed to haematochezia, which generally indicates lower GI haemorrhage. This chapter considers relevant history, physical examination, diagnostic tests and differential diagnoses.

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20.1 Typical appearance of melaena from a dog. Note the coal black appearance.
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20.2 Brown faeces covered with melaena (black faeces). Note the reddish colour diffusing out from the faeces.
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20.3 Overview of the basic diagnostic approach to the patient with melaena. CBC = complete blood count; GI = gastrointestinal; NSAIDs = non-steroidal anti-inflammatory drugs.
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