Bloody Stools In Children - Causes, Symptoms And Remedies

Bloody Stool In Children

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Raising children is an emotional strain, particularly when your child falls sick or exhibits symptoms that seem unusual. Even a slight deviation from the regular may trigger alarm bells as you don’t want anything to go wrong with your child. One very common but considerably unusual symptom that causes panic among parents is blood in the stool of a child, also known as rectal bleeding.

Seeing the slightest streak of blood in your child’s stool can cause a mother to panic. Blood in stool, however, is not always a sign of a serious health problem. Typically, blood in stool is a sign of a digestive trouble or a gastrointestinal infection. Most times, blood in the stool subsides by itself. It could occur due to constipation or other minor digestive concerns. However, if the blood in stools turns out to be a consistent issue, further investigations may be required to diagnose the underlying condition that is causing it.

For your benefit, MomJunction has put together some valuable information on rectal bleeding in children.

Rectal Bleeding In Children:

It is true that seeing blood in your child’s stool can be quite frightening and. But, it will give you some peace of mind to know that 9 out of 10 times, this is something very temporary and does not indicate anything serious. Blood in the stool or rectal bleeding can occur due to a myriad of reasons. The frequency and the amount of blood and the age of your child will determine the seriousness of the condition [1].

While it is true that blood in kids stool will not indicate any serious condition 90% times, your pediatrician may advise a stool examination or other tests to be sure there is no underlying cause for it. Again, this is only done if the blood discharge is too significant or frequent.

[ Read: Diarrhea In Children ]

Types Of Rectal Bleeding In Children:

Rectal bleeding can be bleeding in the upper digestive tract, which includes the stomach and the small intestine or it could be bleeding in the lower digestive tract, colon, rectum, and anus. Depending on where this bleeding begins, the stool may have different types of blood and appearance as described below:

  • If the bleeding is in the upper digestive tract, the stools may appear black or tarry. If left untreated, the condition may even cause the child to vomit out red or black material, something which is similar to coffee grounds.
  • If the bleeding is in the lower digestive tract, the stool usually has streaks of bright red blood. Stools may also be dark maroon in this type of rectal bleeding.
  • Certain foods and medications may also cause the stools to appear bloody. The foods that can cause this include beet, flavored gelatin, red licorice, and red-dyed snacks. Too many chocolates or blueberries can also cause reddish and brownish stools. Medications such as iron supplements and stomach medicines that contain bismuth may also cause the stool to appear dark red.

The appearance of the stool and the amount of blood in it cannot always determine the cause of the rectal bleeding. A proper stool examination will provide the right answers here. The doctors may conduct other tests and examinations based on your doctor’s view after a physical examination. Those tests and investigations are described below.

Symptoms Of Bleeding In Children:

Blood in the stools is the most common symptom but sometimes, the child, or you may not realize there is bleeding. This type of bleeding is referred to as occult bleeding or hidden bleeding, and the pediatrician will be able to diagnose with a simple stool examination. Hence, the doctor will consider other symptoms as well apart from rectal bleeding to pinpoint the actual cause of the hemorrhage.

Along with rectal bleeding, there are symptoms such as changes in bowel movements and pain or tenderness while passing stools that help the doctor determine the cause of rectal bleeding.

Causes Of Blood In Stool In Children:

There can be many causes that lead to rectal bleeding. This gastrointestinal bleeding or blood in the stool may indicate a serious health concern, but not always. In fact, most times, it is not a big deal and will be cured by itself, without the need for medical intervention.

Typically, blood in the stool of children can occur due to different parts of the digestive system. Majorly, your child’s pediatrician will determine the cause of rectal bleeding with a physical examination, but sometimes a more thorough review and investigation may become necessary [2].

Here are some of the most common causes of rectal bleeding.

1. Anal Fissure:

The anal fissure is a small cut in the lining of the anus. This cut usually develops in small babies and toddlers when they are too constipated because of which they pass out hard stools. Though an anal fissure is common in children, it can occur even in adults. The common symptoms of an anal fissure include pain while passing out stool along with straining or grunting during bowel movements. As the blood oozes out from the cut in the anus, the stool has bright red streaks of blood. Treatment of anal fissures is often always accompanied with treatment for constipation and hard stools.

2. Intolerance To Milk Or Soy Protein:

Milk or soy protein intolerance, also known as milk or soy protein-induced colitis is a condition that usually develops in the infants. This is basically a sensitivity to cow-based milk and starts showing up when the baby is introduced to a regular formula. Breastfed babies can also show signs of milk intolerance due to cow based dairy products consumed by the mother. This condition usually resolves by itself as the baby grows and reaches his first birthday.

The symptoms of milk intolerance include consistent vomiting, diarrhea, and blood-tinged stools. Treatment of this condition involves prescribing a special formula that does not have lactose. If you breastfeed your little one, it is best to limit your consumption of dairy products made from cow’s milk until you are breastfeeding.

[ Read: Lactose Intolerance In Children ]

3. Crohn’s Disease:

Crohn’s disease or ulcerative colitis is a condition that causes inflammation of the inner lining of the digestive tract. This inflammation causes bloody stools, diarrhea, and lack of appetite and weight loss.

4. Irritable Bowel Syndrome:

Many children suffer from the Irritable Bowel Syndrome (IBS). This condition causes bouts of constipation and diarrhea. The irregular bowel movements cause pain and discomfort as well as blood in stools. Bleeding is not due to the condition specifically, but due to the constant diarrhea and strain by the movements of the irritable bowel.

[ Read: Irritable Bowel Syndrome In Children ]

5. Breastfeeding:

Sometimes, babies who are breastfeeding may ingest some blood from their mother’s cracked nipples. Although the amount of blood ingested might be just a couple of drops, it is still a significant amount for little infants, and it may show up in their stools.

6. Infectious Diarrhea:

Caused by a bacterium, virus or a parasite, infectious diarrhea is common in pre-school children, primary school children as well as in adolescents. This condition develops when the child consumes contaminated food or drinks. Blood-tinged stool is a common symptom of this condition.

7. Juvenile Polyps:

These polyps grow in the inner lining of the colon. Usually, children between the ages of two and 10 tend to develop juvenile polyp. A single polyp may not indicate a cancerous or a precancerous condition but require an evaluation by a health care provider. The best treatment is removal of the polyps. If you don’t remove them, your child will experience painless rectal bleeding.

8. Meckel’s Diverticulum:

This is a congenital condition which develops due to the presence of a leftover piece of the umbilical cord in the lowest part of the small intestine of the baby. This remaining part may contain cells of the stomach that secrete acids, causing rectal bleeding along with ulcers in the baby.

9. Blood-Related Problems:

Blood clotting disorders, abnormalities of blood vessels can also cause rectal bleeding. In this case, there may be other accompanying symptoms such as skin rashes and easy bruising.

10. Other Issues:

Rectal bleeding may also indicate some other severe conditions such as intussusceptions or Hirschsprung’s disease.

As already mentioned, rectal bleeding may not always be a serious issue. However, locating the right cause and source of bleeding is essential to treat it. The bleeding is usually due to bleeding in the digestive tract. The digestive tract includes the esophagus, stomach, small and large intestines, colon, rectum, and anus. Bleeding can initiate in any of these organs and can be due to a small cut, an ulcer or inflammation [3].

Clinical Examinations And Diagnosis For Rectal Bleeding:

1. Stool Examination:

A superficial examination of the anus can help in determining the cause of rectal bleeding. A stool exam is the most common clinical examination and laboratory test conducted to determine the cause of rectal bleeding. The stool examination will test the stool for the presence of blood, bacteria, virus or parasite.

Most of the times, a stool examination is all that is needed to understand the real cause of rectal bleeding. Further testing may be necessary if the stool test does not provide a clear picture of the underlying cause of the condition. Your pediatrician may recommend further investigations when a simple anal examination cannot determine any anal fissures.

2. Endoscopy Or Colonoscopy:

The doctor may recommend endoscopy or colonoscopy to find out the reason for the hemorrhage. Colonoscopy is the examination of the lower part of the gastrointestinal tract. The doctor will insert a thin tube with a camera into your little one’s digestive tract. This will allow the doctor to examine the inner lining of the colon. The endoscope allows the physician to clearly see the colon and determine if there are any lesions and thereby confirm the source of bleeding. Endoscopy can be done to examine the esophagus, stomach, duodenum, and the colon. The procedure is also used to collect small tissues needed to conduct biopsies.

3. Ultrasound Scans:

In certain cases, the child may need ultrasound scans. If necessary, the doctor may also request for X-rays to see if there are structural abnormalities or obstructions causing the bleeding. However, an endoscopy is the preferred method of diagnosis as it also allows the option conduct a biopsy, if need be.

4. Blood Test:

The site or source of bleeding must be located to treat the cause of rectal bleeding. Your child’s doctor may also check your child’s blood count to understand if he is anemic. A test of the blood count will also indicate the extent of rectal bleeding as well as how chronic it is. Your child’s pediatrician may advise tests based on the child’s medical history and symptoms.

[ Read: Constipation In Children ]

When To Call The Doctor?

The symptoms and causes mentioned earlier may give you a fair idea of what rectal bleeding may be and how a doctor can diagnose it. Now the question is when you should reach out to your child’s doctor. Here is a list of issues that you definitely should not ignore and contact your health care provider immediately.

  • Your child appears to be very sick
  • Significant bleeding visible in your child’s stool
  • Black or dark stools not once but consistently
  • Vomiting with blood
  • Severe abdominal pain
  • Skin bruises that are not related to any injury
  • Physical injury at the site of anus or rectum [4]

If your little one has one or more of these, your child requires a medical checkup to identify the exact cause of the rectal bleeding. And, you need to do is as quickly as possible to avoid complications and ensure you kid gets the right treatment at the right time. It is best to initially consult your child’s regular pediatrician who will then suggest a specialist pediatric gastroenterologist based on the results of the clinical examinations and investigations.

Blood In Stool In Children Aged 5, 7, And 10 Years:

Rectal bleeding can cause a lot of anxiety in the minds of parents. It is true that rectal bleeding is less common in children than in adults. However, it is not a serious symptom even if it occurs in smaller babies.

To examine the cause of blood in stools, the age of the child is a significant factor of consideration. For instance, in babies less than 12 weeks old, blood in stools can be taken a little more cautiously by medical practitioners because these babies are either exclusively breastfed or are on formula. In both cases, rectal bleeding could most probably be due to milk or soy protein intolerance. In this case, a substitute has to be immediately prescribed for the baby.

In the toddlers aged 2 to 5 years, the cause of rectal bleeding is often due to digestive problems caused because of consumption of contaminated food or due to viral or bacterial infections. Children this age should be carefully monitored for their food consumption. Anal fissures are also common in this age. Self-care or home care is ideal for children this age.

Children in the age group of 5 to 7 years are more prone to anal fissures caused due to constipation. Giving children enough water and fiber-rich foods are important in this age so that they do not develop chronic constipation. If your child does not show improvement with home care and after consuming fiber-rich foods, it is advisable to consult your pediatrician right away. Your doctor may prescribe your child some suppositories and laxatives to prevent rectal bleeding.

In older kids, aged 10 and above, the pattern of rectal bleeding is more or less similar to that in adults. The bleeding is usually a result of anal fissures, hemorrhoids, juvenile polyps or IBD. Endoscopic examination in children is conducted to examine if there are polyps or other internal issues causing the bleeding. The procedure is conducted under general anesthesia by specialist pediatric gastroenterologists [5].

Treating Rectal Bleeding Or Bloody Stool In Children:

Blood in stools of children is not something very uncommon. Especially in school-going children, this occurs rather often due to consuming various contaminated foods. Most of the times, rectal bleeding is due to a benign source like a small tear in the inner lining of the anus. This type of rectal bleeding can be treated with fluids, stool softeners, and lubricants that will make stool passage easier and less painful.

1. Laser Therapy:

An endoscopy can be a great tool not just for diagnosis but also for treatment. The doctor can use the endoscope to inject medication directly into the bleeding site to control the bleeding. Laser therapy is also possible through an endoscope. It is also possible to treat the site with a heater probe or an electrocoagulation device attached to the endoscope. When endoscopy is not successful, surgery may be recommended [6].

[ Read: Encopresis In Children ]

2. Medication:

Once the doctor controls the bleeding, your child’s pediatrician may prescribe drugs that will prevent recurrence of rectal bleeding by majorly focusing on ensuring that your child’s stools are soft and less straining to pass. Most of these medicines are offered to treat ulcers, infections, and irritable bowel movements. If the case is of juvenile polyps, removal of these polyps will stop and cure the bleeding. Here, polyps can again be removed with an endoscope. So it will not be an invasive procedure.

Natural Home Remedies For Blood In Stools:

Rectal bleeding does not always need medical intervention. If it is a minor concern which doesn’t cause a lot of pain, blood in the stools could be due to an anal fissure or hemorrhoids. In these cases, home therapy can be considered. However, if the bleeding is significant and consistent, it is best to get your child clinically examined to evaluate the real cause and adopt the necessary treatment procedure.

Self-care or home care for rectal bleeding includes the use of some over-the-counter rectal ointments and suppositories. These are usually available at most pharmacies without a prescription. If the symptoms do not improve within a week or if your baby is under 12 weeks of age, it becomes essential to consult a medical practitioner [7].

Some simple self-care tips include:

  • Keeping your child well hydrated is essential. As a matter of fact, a glass of water first thing in the morning is considered to be highly effective.
  • Bathe or sponge the area around anus daily to keep the skin clean and prevent any further infections.
  • If your baby uses disposable diapers, it is best to discontinue the use till the condition goes back to normal or make sure you change your little one’s diapers more frequently.
  • Increase fiber in the diet. This will bulk up the stool and allow your child to pass it out without pain or straining. It is important to understand that constipation is often the leading cause of an anal fissure. Consuming plenty of green leafy vegetables, and fiber-rich fruits and fruits juices can be extremely helpful in treating chronic constipation.
  • Apply ice packs to the area around the anus to reduce the pain from straining and fissures. Remember not to keep the ice pack longer than 10 minutes at a time.
  • A Sitz bath is also highly recommended. This is a warm water bath, and your child sits in the water. The warm water covers your little one’s hips and thighs. You can add an antiseptic to the warm water to make it even more effective in relieving the pain and discomfort.

Blood in stools needs careful evaluation only if it is something that is a consistent issue with your child. However, if it is not something that is persistent, you can follow home remedies and take care that your child has fiber-rich food. This will prevent hard stools and thereby, reduce chances of rectal bleeding that can be due to anal fissures.

Did your child ever suffer from rectal bleeding? What did you do about it? Tell us here.

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