When parents observe blood in their child’s stool, it often prompts immediate concern. This symptom can be unsettling, and while it consistently warrants medical attention, its underlying causes can range from minor and easily treatable conditions to more serious health issues. Understanding the potential reasons behind this observation can help parents approach the situation with informed awareness.
Identifying Blood in Stool
Blood in a child’s stool offers clues about the source of bleeding. Bright red blood, appearing as streaks or mixed in, indicates bleeding from the lower gastrointestinal tract. In contrast, dark, tarry stools, known as melena, suggest bleeding higher up in the digestive system, where blood has been digested. Sometimes, invisible blood can be detected through laboratory tests, known as occult bleeding. Certain foods, such as red-colored drinks or beets, or medications like iron supplements, can mimic blood’s appearance.
Common Causes in Children
Anal fissures are a common cause of bright red blood in a child’s stool. These small tears in the skin around the anus result from passing hard or large stools. The bleeding is minor, appearing as streaks or on toilet paper, and is accompanied by pain during bowel movements.
Dietary factors, particularly milk protein allergy, cause blood in the stools of infants. The immune system reacts to cow’s milk proteins, causing intestinal lining inflammation. This inflammation results in microscopic or visible streaks of blood.
Infectious gastroenteritis may cause bloody diarrhea. Certain bacterial infections irritate and damage the intestinal lining, causing inflammation and blood in loose stools. Children may experience fever, vomiting, and abdominal pain.
Swallowed blood appears in a child’s stool. Blood from a nosebleed, bleeding gum, or mouth cut passes through the digestive system, appearing as red or dark specks.
Diaper rash, especially severe cases, causes superficial bleeding. The irritated skin may ooze or bleed, transferring to the stool or diaper.
Less Common, More Serious Causes
Juvenile polyps are benign growths in the colon or rectum. These polyps bleed easily, causing painless, bright red blood on the stool or toilet paper.
Meckel’s diverticulum is a congenital abnormality: a small pouch in the small intestine. This pouch may produce acid, causing ulceration and bleeding. Resulting in painless, dark red or maroon-colored blood in the stool.
Inflammatory Bowel Disease (IBD) involves chronic inflammation of the digestive tract. Ulcerative colitis affects the large intestine and rectum, causing bloody diarrhea, abdominal pain, and weight loss. Crohn’s disease can affect any part of the digestive tract; bloody stools are more common in ulcerative colitis.
Intussusception is a condition where one segment of the intestine “telescopes” into an adjacent segment. This obstructs the bowel and cuts off blood supply, causing severe abdominal pain, vomiting, and stools resembling “currant jelly” (blood and mucus).
Bleeding disorders impair blood clotting. These disorders cause bleeding, including blood in the stool.
When to Seek Medical Attention
Blood in a child’s stool should prompt a discussion with a pediatrician. Seek immediate medical attention if a newborn has blood in their stool, as this indicates a serious issue.
Significant blood, persistent bleeding, or blood with other symptoms require prompt evaluation. These symptoms include severe abdominal pain, fever, repeated vomiting, or signs of dehydration. Dark, tarry stools (melena) also require urgent assessment, as this indicates bleeding from higher up in the digestive tract. If the child appears unwell, pale, or not acting normally, seek immediate medical consultation.
Diagnostic Process and Management
Medical evaluation for blood in stool begins with a detailed history. Questions cover the blood’s appearance, quantity, duration, and associated symptoms like pain, fever, vomiting, and appetite/activity changes. Diet, recent illnesses, and medications are also gathered.
Physical examination includes checking the child’s abdomen and visually inspecting the anal area. Diagnostic tests may be considered. Tests include stool tests for occult blood, bacterial/viral infections, or inflammation/allergy markers. Blood tests assess for anemia, inflammation, or clotting disorders. Imaging studies like X-rays or ultrasounds visualize the digestive tract.
Invasive procedures like endoscopy or colonoscopy are reserved when other tests are inconclusive or a serious condition like inflammatory bowel disease or polyps is suspected. Management depends on the cause; minor issues need reassurance and dietary adjustments, while serious conditions need targeted interventions.