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Clinical Features The key facts to ascertain from a patient presenting with melena are: Colour and texture of the stool best described as a jet black, tar-like, and sticky Associated symptoms including any haematemesis, abdominal pain, weight loss, dyspepsia, or dysphagia Past medical history including smoking and alcohol status Drug history use of steroids, NSAIDs, anticoagulants, or iron tablets* A digital rectal examination is essential to confirm the melena