What causes black, tarry stools and bleeding in cirrhosis?

The main causes of black tarry stools (melena) in patients with cirrhosis include: 1. **Rupture of esophageal and gastric varices**: This is the leading cause of upper gastrointestinal bleeding in cirrhosis, accounting for 60% to 75% of cases. Significant bleeding can lead to shock and is considered a life-threatening emergency. 2. **Peptic ulcer bleeding**: Including gastric and duodenal ulcers, this accounts for 15% to 30% of cases. It mainly presents as melena and less commonly as hematemesis (vomiting blood). 3. **Portal hypertensive gastropathy bleeding**: This accounts for 10% to 20% of cases and typically presents with melena as the main symptom. 4. **Other less common causes**: These include concomitant conditions such as reflux esophagitis, esophageal cancer, gastric cancer, and biliary tract diseases that may also lead to bleeding.