If a patient’s stool appears like coffee grounds, what might this indicate?

The appearance of a patient's stool resembling coffee grounds typically indicates the presence of partially digested blood, known as melena. This occurs when there is a bleeding source in the upper gastrointestinal tract, such as an ulcer or esophageal varices, which causes the blood to mix with gastric juices and then be expelled in the stool. The dark, granular appearance mimics coffee grounds due to the digestion of the blood and the effects of acid in the stomach.

Colitis refers to inflammation of the colon and may lead to other symptoms but does not typically cause stool to resemble coffee grounds specifically. Hematochezia, which is the passage of fresh red blood from the rectum, usually indicates lower gastrointestinal bleeding and would not present in the same manner as melena. Hemorrhoids can cause blood in the stool but more commonly results in bright red blood on toilet paper or in the stool, not the coffee-ground appearance associated with upper GI bleeding. Hence, melena is the most fitting interpretation of stool appearing like coffee grounds.