melanotic or melena melanotic stool color MALENA: Melena

Mod Rheumatol 28(3):506512

JAAOS Glob Res Rev

he diverse microflora in the human large intestine metabolizes these fibers, producing significant amounts of short-chain fatty acids (SCFAs), mainly propionate, acetate, and butyrate

Haematological symptoms often appear first and include: Fatigue and weakness due to anaemia Pallor (pale skin) Shortness of breath, particularly on exertion Heart palpitations Glossitis (sore, red tongue) Mouth ulcers Neurological manifestations can be particularly concerning and may include: Paraesthesia (pins and needles) in hands and feet Peripheral neuropathy causing numbness or altered sensation Difficulty walking or balance problems (ataxia) Memory problems and cognitive difficulties Mood changes, including depression or irritability Rare optic neuropathy in severe cases Other symptoms that may occur include: Digestive disturbances Loss of appetite and weight loss Generalised weakness It is crucial to note that neurological symptoms can occur even in the absence of anaemia, and you should contact your GP urgently if you experience persistent paraesthesia, balance problems, memory difficulties, or unexplained neurological symptoms