STOOLS, BLOOD IN
Symptom Definition
- Blood-colored material mixed in with the stool, on the surface or passed separately
- Blood in the stools is usually bright red
- Blood from bleeding in the stomach comes out tar-black
Causes
- Anal Fissure: If no associated diarrhea, more than 90% of children with blood in the stools have an anal fissure. Anal fissures usually are caused by passage of a large or hard bowel movement.
- If associated diarrhea, most of the children have Shigella, Salmonella or Campylobacter infections.
- Some foods (e.g., tomatoes) and some medicines can also cause red-colored stools that look like blood.
See More Appropriate Topic (instead of this one) If
- Also has diarrhea, see DIARRHEA
WHEN TO CALL YOUR DOCTOR
Call 911 now (your child may need an ambulance) if:
- Fainted or too weak to stand
Call your doctor now (night or day) if:
- Your child looks or acts very sick
- Large amount of blood, blood alone without any stool or the toilet water turned red
- Tarry or black-colored stool
- Blood with diarrhea
- Pink- or tea-colored urine
- Vomited blood
- Abdominal pain or crying also present
- Skin bruises not caused by an injury
- Age under 12 weeks
- Small bleeding occurs more than 2 times
- Followed an injury to anus or rectum
Call your doctor within 24 hours (between 9am and 4pm) if:
- Blood in the stools, but none of the symptoms described above (probably anal fissure)
- NOTE: Try to save a sample of the "blood" for testing if your child needs to be seen
HOME CARE ADVICE(Pending Talking with Your Doctor)
- Definition: An anal fissure is the #1 cause of blood in stools
- The blood is bright red, but only a few streaks or flecks are present
- All the blood is on the surface of the stool or on the toilet tissue after wiping
- Usually follows passage of a large or hard bowel movement (BM)
- You may see a shallow tear at 6 or 12 o'clock on the anus
- Warm Saline Baths: Give warm saline baths for 20 minutes 2 times per day for 1 day to cleanse the area and to promote healing. Add 2 oz. of table salt or baking soda to a tub of warm water.
- Steroid Ointment: If the anus seems irritated, apply 1% hydrocortisone ointment 3 times per day for 1 day to help healing.
- High-Fiber Diet:
- For children more than 1 year old, offer a nonconstipating diet.
- Increase fruits, vegetables and grains (fiber).
- Reduce milk products to 3 servings per day.
- If CONSTIPATION is definitely the cause, see that topic.
- Expected Course: Anal fissures usually heal up quickly with home treatment.
- Call Your Doctor If:
- Bleeding increases in amount
- Small bleeding occurs over 2 times
- Your child becomes worse
And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.
REFERENCES
- Nelson JS. Red stools and Omnicef. J Pediatr. 2000; 136: 853-854.
- Silber G. Lower gastrointestinal bleeding. Pediatr Rev. 1990;12:85-92.
- Squires RH Jr. Gastrointestinal bleeding. Pediatr Rev. 1999;20(3):95-101.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
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