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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

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Direct injury, as in wounding and burning

Acknowledgements This work was supported by the Research Grant from Seoul National University (370C-20210102) in 2021 and grants from the National Research Foundation of Korea (NRF) (2022R1A6A3A13071509 to Y.K.C., NRF-2019R1C1C1002014 to Y.H.L., and NRF-2018R1A5A2024425 to Y.H.L.) funded by the Korean government (MSIT)

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